Current status of the diagnosis and treatment of gastrointestinal schwannoma (Review)

Zhou, Qi; Yang, Naixv; Pi, Mengqi; Yu, Wei

doi:10.3892/ol.2021.12645

Cited by 16 publications

(34 citation statements)

References 57 publications

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“…Although gastric schwannomas are slow-growing tumors, some researchers recommend surgical resection as they may become malignant. [ 5 ] In contrast, all gastric leiomyomas are virtually benign; thus, they can be followed-up without invasive treatment. Consequently, the differentiation of gastric leiomyomas from other GIMTs is important to ensure appropriate clinical management.…”

Section: Discussionmentioning

confidence: 99%

Scoring systems for differentiating gastrointestinal stromal tumors and schwannomas from leiomyomas in the stomach

et al. 2021

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There is no practical predictive model for the diagnosis of gastrointestinal stromal tumors (GISTs). To establish a practical predictive model for the diagnosis of subepithelial lesions in the stomach, we reviewed patients with GISTs (n = 89), schwannomas (n = 7), and leiomyomas (n = 28). The tumor was more frequently found along the gastric cardia in the leiomyoma group (57.1%) than in the GIST/schwannoma group (2.1%, P < .01). Contrast enhancement (57.3% vs 0%, P < .01) and intra-tumoral necrosis (34.4% vs 0.0%, P < .01) were more frequently observed in the GIST/schwannoma group than in the leiomyoma group. On endoscopic ultrasonography, 58.3% of GISTs/schwannomas showed uneven echogenicity, whereas the echogenicity was uneven in 21.4% of leiomyomas ( P < .01). There were no differences between the tumor color and the presence or absence of ulcer formation, tumor bleeding, irregularity of the tumor margin, cystic spaces, and hyperechoic spots between the 2 groups. Based on these results, we developed a 2-step diagnostic algorithm for GISTs/schwannomas. The first step comprises 1 endoscopic feature: a cardiac or non-cardiac location. Tumors with a cardiac location were judged as leiomyomas and those with a non-cardiac location were judged as GISTs/schwannomas, with 96.9% sensitivity and 57.1% specificity for GIST/schwannoma diagnosis. The second step comprises a combination of endoscopic (non-cardiac location), radiologic (positive contrast enhancement and intra-tumoral necrosis), and endosonographic (uneven echogenicity) features for a total of 4 points. We assigned 1 point to each feature. Tumors with scores of 2 to 4 were judged as GISTs/schwannomas, with 81.3% sensitivity and 92.9% specificity for GIST/schwannoma diagnosis. Our predictive model will be a practical guide for the management of gastric subepithelial lesions.

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Section: Discussionmentioning

confidence: 99%

Scoring systems for differentiating gastrointestinal stromal tumors and schwannomas from leiomyomas in the stomach

et al. 2021

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“…S100 is a specific marker for GISs with a positive expression rate of 97.6%-100%. Other occasionally positive markers reported included Vimentin, CD34, and SOX10 (3,4). Negative expression of other markers such as Dog-1, CD117, SMA, and desmin is useful for differentiating GISs from other mesenchymal tumors such as GIST and leiomyoma.…”

Section: Discussionmentioning

confidence: 99%

“…Gastrointestinal SMTs, also called mesenchymal tumors, comprise 0.1% to 3% of all gastrointestinal tumors, and they consist of a spectrum of spindle cell tumors, mainly including gastrointestinal stromal tumor (GIST), leiomyoma or leiomyosarcoma, and schwannoma ( 2 ). Schwannomas arise from the Schwann cells in nerve sheaths, which grow slowly and can occur in any part of the body but are rarely seen in the gastrointestinal tract ( 3 , 4 ). GIS was first reported by Daimaru in 1988 ( 5 ), and it is being diagnosed more frequently with recent advances in diagnostic technology and immunohistochemistry (IHC).…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological characteristics of gastrointestinal schwannomas: A retrospective analysis of 78 cases

et al. 2022

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IntroductionSchwannomas are tumors arising from Schwan cells of the neural sheath, which rarely occur in the gastrointestinal tract. The aim of the present study was to analyze the clinicopathological features and treatment outcomes of gastrointestinal schwannomas (GISs).MethodsPatients who were diagnosed with GISs in our hospital from January 2010 to December 2021 were selected. Data about demographic characteristics, clinical symptoms, treatment methods and outcomes, pathological results, and follow-up results were retrospectively collected and analyzed.ResultsA total of 78 patients with 79 GISs were included, the female-to-male ratio was 55:23, and the average age was 52.12 ± 12.26 years. One-third (26/78) of the patients were asymptomatic. A total of 79 GISs were removed, and the average size was 3.63 ± 2.03 cm (range, 0.3–10 cm). As for tumor location, 54 GISs were located in the stomach, 14 in the esophagus, 2 in the duodenum, 6 in the colorectum (4 in the colon and 2 in the rectum), and the other 3 in the small intestine. A total of 23 and 55 patients underwent endoscopic and surgical resections, respectively. Compared with surgical resection, endoscopic resection is associated with a smaller diameter, lower cost, and shorter hospital stay. Pathological results revealed that S100 was positive in all the GISs. No recurrence was noticed during a median follow-up of 45 months (range, 6–148 months).ConclusionGISs are rare gastrointestinal tumors with favorable prognoses, which are most commonly seen in the stomach and diagnosed by pathological findings with immunohistochemical staining. Surgical resection remains the standard method for removing GISs, while endoscopic resection may serve as an alternative method for selected patients with GISs and may be attempted in GISs with a diameter of <3 cm and no signs of malignancy.

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“…This patient had complete excision. Recurrences after complete excision are associated with rare malignant variants and the prognosis is poor 18 . Unfortunately, our patient had a recurrence and we eventually lost him to follow while preparing him for repeat surgery.…”

Section: Ct Image Showing a Huge Central Abdominal Mass (Arrow)mentioning

confidence: 99%

“…It could be neuropathic or from the scar. The use of multimodal analgesic techniques 18 could reduce the incidence. Pain could also signal the onset of recurrence.…”

Section: Ct Image Showing a Huge Central Abdominal Mass (Arrow)mentioning

confidence: 99%

A Huge 5kg-Intra-Abdominal Ancient Schwannoma with A Recurrence-A Case Report

ADEYANJU¹

2022

IJRSI

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Introduction- This is a rare case of a recurrent huge intrabdominal Ancient Schwannoma, the size of which has not been reported before. This case report aims to enrich the literature on cases of undiagnosed abdominal masses. Clinical features-The patient complained of huge abdominal distension, weight loss, and breathlessness of 4 months duration. The important clinical findings were multiple cutaneous painless swellings, hyperpigmented patches on the trunk, and a mass occupying the whole of the abdomen. Management-A diagnosis of visceral manifestation of neurofibromatosis was made to rule out an intra-abdominal malignancy. Preoperative Abdominal Computed Tomography (CT) scan revealed a huge intrabdominal mass while a CT-guided biopsy showed a Benign Mesenchymal tumor. He had an exploratory laparotomy, and the mass was totally excised. The recovery was uneventful, and the outcome was excellent. Histopathology showed that the tumor was a Schwannoma with no malignancy. However, 5 months after, the swelling recurred and he was eventually lost to follow up. Conclusion- The rarity of Intra-abdominal Schwannomas and absent or non-specific signs and symptoms present the surgeon with a diagnostic dilemma. Preoperative Abdominopelvic CT scan, Ultrasound scan, and Magnetic Resonance Imaging are necessary imaging modalities. Complete excision at surgery reduces recurrence. Close follow-up is essential.

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Current status of the diagnosis and treatment of gastrointestinal schwannoma (Review)

Cited by 16 publications

References 57 publications

Scoring systems for differentiating gastrointestinal stromal tumors and schwannomas from leiomyomas in the stomach

Scoring systems for differentiating gastrointestinal stromal tumors and schwannomas from leiomyomas in the stomach

Clinicopathological characteristics of gastrointestinal schwannomas: A retrospective analysis of 78 cases

A Huge 5kg-Intra-Abdominal Ancient Schwannoma with A Recurrence-A Case Report

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