Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass

Yoon, William; Paulson, Kari; Mazzara, Paul; Nagori, Sweety; Barawi, Mohammed; Berri, Richard N.

doi:10.1155/2012/280982

Cited by 32 publications

(38 citation statements)

References 12 publications

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“…Imaging findings are nonspecific; CT scans show well-defined, homogeneous mural masses, and can help to distinguish schwannomas from gastrointestinal stromal tumors (GISTs), which are heterogeneous masses (12). On most occasions, diagnosis is not established based on a biopsy but on a surgical specimen (13).…”

Section: Discussionmentioning

confidence: 99%

Schwannoma of the colon: A case report and review of the literature

et al. 2016

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Abstract. Colonic schwannomas are rare gastrointestinal mesenchymal tumors, and only a limited number of cases has been reported. The occurrence of these tumors is less common in the large intestine than in the stomach. The present study reports a case of colonic schwannoma in a 62-year-old female patient with no specific symptoms. The patient was diagnosed with a mass in the ascending colon by colonoscopy and abdominal computed tomography scanning. A right hemicolectomy was performed. The postoperative pathological diagnosis was ascending schwannoma. This case is noteworthy as colonic schwannomas are rare and are typically treated as colon cancer. No recurrence of the lesion was observed after 24 months of follow-up.

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Section: Discussionmentioning

confidence: 99%

Schwannoma of the colon: A case report and review of the literature

et al. 2016

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“…CT shows a well-defined homogeneous mural mass and differentiates them from GISTs (gastrointestinal stromal tumours), which are heterogeneous masses (8). On most occasions diagnosis is not established from the biopsy, but from the surgical specimen (9).…”

Section: Discussionmentioning

confidence: 99%

Schwannoma in descending colon: presentation of a neoplasm in a rare location

Verdú-Fernández

Guillén-Paredes

García-García

et al. 2013

Rev. esp. enferm. dig.

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Schwannomas of the gastrointestinal tract are uncommon tumours originating in the cells of Schwann of the peripheral nerves and accounting for 2-6 % of all mesenchymal tumours. They usually appear in the stomach or small intestine and less frequently in the colon. Case reportWe present a 67-year-old male in whom a screening colonoscopy revealed an ulcerated polypoid lesion 35 cm from the anal margin. The biopsy was unspecific. CT and virtual colonography showed a 4.5 x 3.6 x 3.7 cm polypoid mass in the left colon with regional adenopathies but no distant metastases. The patient was admitted to the emergency department for rectorrhage and abdominal pain. Ultrasonography showed a colico-colic invagination caused by the polypoid mass. The patient underwent a midline laparotomy, which revealed an invagination in the descending colon, but no infiltration or distant dissemination. A segmental colectomy was performed with a mechanical sideto-side anastomosis. The patient evolved favourably. The anatomopathological study informed of a well-circumscribed yellowish-white submucosal tumour made up of spindle cells forming palisades, an intratumoural lymphoid infiltrate with peripheral nodules, and low mitotic activity. Immunohistochemical tests were positive for S-100 and CD68 but there was no reactivity for CD117, CD34, actin and CD10 (Fig. 1). The definitive diagnosis was schwannoma of the colon. No recurrence has been observed in 3 years of follow-up. DiscussionSchwannomas are common in subjects with von Recklinghausen's disease (1,2). The colon is a rare location, and when they appear they are most often found in the caecum, followed by the sigmoid colon, transverse colon, descending colon (as in our case) and finally the rectum. They are benign neoplasms that rarely degenerate (3). They usually present as a polyp which may ulcerate the mucosa (4,5) and lead to unspecific symptoms such as abdominal pain with rectal bleeding, defecation disorders, colonic obstruction or invagination, as in our patient (6,7). Imaging tests are unspecific. CT shows a well-defined homogeneous mural mass and differentiates them from GISTs (gastrointestinal stromal tumours), which are heterogeneous masses (8). On most occasions diagnosis is not established from the biopsy, but from the surgical specimen (9).Macroscopically they are well-circumscribed yellowish-white lesions. Microscopically they are arranged in a pattern of intertwined bundles surrounded by an infiltrate of lymphoid cells with germinal centres and small foci of cellular atypia with low mitotic activity (10). An immunohistochemical study is very useful for a differential diagnosis with other lesions such as GISTs, GANTs (a variant of GISTs derived from the autonomic nerves), leiomyomas or leiomyosarcomas, which can show a more aggressive behaviour (11). Schwannomas usually express a positive reaction for S-100, vimentin and GFAP, but no reactivity for the transmembrane receptor tyrosine kinase known as c-KIT or CD117, the precursor cell antigen of the haematopoyetic system CD...

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“…3 According to the latest research report, Gastric schwannomas often occur in individuals between the ages of 50 to 60 years old, and most of them are usually solitary lesions, arising from the lesser curvature of the stomach, low probability of occurrence in the digestive tract. [4][5][6] They are often asymptomatic or with mild abdominal discomfort discovered incidentally at laparotomy or radiographically. 7 They are always misdiagnosed as gastrointestinal stromal tumor because of its low incidence in clinical.…”

Section: Introductionmentioning

confidence: 99%