Gastric Schwannoma: A Case Report

Abstract

Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic. The preoperative diagnosis via endoscopy is a challenging issue due to the difficulty of differentiation from other submucosal tumors. A 54-year-old woman presented with epigastric pain persisting for the last 10 months. Upper endoscopy revealed an elevated submucosal mass of the gastric antrum. The overlying mucosa was normal. Biopsy specimens yielded only unspecific signs of mild inactive chronic inflammation. Endoscopic ultrasound examination noted a hypoechoic homogeneous mass lesion located in the gastric antrum. The mass appeared to arise from the muscularis propria, and there was no perigastric lymphadenopathy. A contrast-enhanced computed tomography scan identified a homogeneous round mass and arising from the antrum of the stomach. Submucosal tumor was suspected and surgical intervention was recommended. The patient underwent an elective laparoscopic partial gastrectomy. The histopathologic features and immunohistochemical-staining pattern were consistent with a benign gastric schwannoma. Our patient shows no recurrence with a follow-up of one year. The definitive diagnosis of gastric schwannomas requires immunohistochemical studies. Complete margin negative surgical resection, as in this case, is the curative treatment of choice. The clinical course is generally benign.

Schwannomas of Gastrointestinal Tract; a comprehensive review

“…Sometimes these tumors are picked up coincidentally [32] during routine endoscopic screening [34] or by endoscopic evaluations prompted by changes in bowel habits, abdominal pain, [13] GI bleeding, [4,13,14] difficulty in defecation [1,9] or positive occult blood tests performed during colorectal screening [23,35]. When they occur in stomach, the commonest site of these tumors, they are usually asymptomatic [36,37] and in the subset of symptomatic patients, presentation due to bleeding as the first symptom is seen in 14% cases; and this usually in the form of melena and rarely as hematemesis [36].…”

“…Other presentations of GIS in stomach, include epigastric pain persisting for many months, [37] vomiting, weight loss, perforation, with abscess formation, and rarely pleural effusion [13]. The presentation of malignant GIS is similar to non-malignant GIS [19].…”

“…Size and location of these tumors and their relation to surrounding structures determine the type of operation [13]. Wedge resection, partial or subtotal gastrectomy, elective laparoscopic gastrectomy, [37] Int J Case Rep Images 2018;9:100945Z01HT2018. www.ijcasereportsandimages.com Ting et al 6 could be done for SNs in stomach [13,41].…”

“…Endoscopic resection [34], laparoscopic hemicolectomy, [47] and endoscopic-laparoscopic resections, [36] Endoscopic mucosal resection (EMR) [34], are treatment options for tumors arising from other parts of GIT. Complete surgical resection with tumor-free margins is the curative treatment of choice for GI Schwannomas, in general, irrespective of their location [7,37].…”

Schwannoma of the vagina - a common tumor but a rare location: A case report

“…In 3–4% of the patients, schwannomas of the head and neck are incidentally discovered at autopsy ( 3 ). Apart from cranial nerves, schwannomas may be observed in other sites, such as the tongue ( 4 ), stomach ( 5 ), colon ( 6 ), knee ( 7 ) and penis ( 8 ); however, it is highly unusual for schwannomas to be encountered in the genital tract.…”