Natural history of gastrointestinal schwannomas

Abstract

Background and study aims Data are lacking on the natural history of gastrointestinal tract schwannomas. We aimed to study the natural history of all gastrointestinal schwannomas including location, diagnosis, management, and long-term outcomes. Patients and methods Patients with a pathological diagnosis of gastrointestinal schwannoma between January 2000 and March 2020 were identified. Data on baseline demographics, presentations, associated malignancies, malignant transformation, treatment, and recurrence were collected. Results Our cohort consisted of 44 patients with a mean age of 58.6 years, with 63.6 % women and 84.1 % White. The stomach (38.6 %) was the most common location followed by the colorectum (31.8 %). Only 22.7 % of patients were symptomatic and 22.0 % had a personal history of other malignancies. Tissue diagnosis was obtained via endoscopy in 47.7 % and from surgical pathology in 52.3 %. On histology, 65.9 % of the tumors were solid, 11.4 % had mixed features, and 2.3 % had necrosis. SP100 was tested in all but one patient and was positive in all. Mean Ki-67 in 12 patients with tumors measuring ≥ 2 cm was 3.0 % indicating a low proliferation rate. Of the patients, 77.3 % had surgery and 18.2 % underwent endoscopic resection. At a mean follow-up of 5.0 ± 4.31 years, there was no malignant transformation, recurrence or mortality associated with gastrointestinal schwannomas. Conclusions Gastrointestinal schwannomas are diagnosed in the fifth to sixth decade with predominance in women and Whites. They are benign, mostly asymptomatic, and diagnosed incidentally. Asymptomatic gastrointestinal schwannomas including lesions ≥ 2 cm in size do not appear to need further monitoring or intervention. Patients with them should be counseled to remain up to date with routine screening guidelines pertaining to the colon, breast, and lung cancer due to the high incidence of concomitant malignancy.

Rare retroperitoneal giant sacral schwannoma: A case report

“…Vimentin-positive expression also suggests a tumor originating from neural tissues (33). Ki-67 is a nuclear antigen that reflects cell proliferative activity (34,35). In the present case, the Ki-67 index of the original tumor was 1%, which indicated a benign tumor, and there was a low recurrence rate.…”

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

“…GISs are rare gastrointestinal mesenchymal tumors and account for about 2%–6% of all gastrointestinal mesenchymal tumors ( 3 ). GISs are most commonly located in the stomach (60%–80%), followed by the colon and rectum, and are even rare in the esophagus and small intestine ( 3 , 19 ). In the present study, GISs account for 3.71% of gastrointestinal SMTs, and 67.9% (53/78) of them were located in the stomach, which was consistent with previous studies.…”

“…Gastric schwannomas are more commonly located in the gastric body (56.5%–90.3% as reported) ( 6 , 7 , 17 , 20 – 25 ), and 72.2% (39/54) were located in the gastric body in our study. GISs occur more frequently in women, with a female-to-male ratio of up to 2:1 or higher ( 3 , 4 , 19 ). The female-to-male ratio was 2.39:1 (55:23), which is in accordance with that found in the literature.…”

“…In the present study, the mean age was 52.12 years, 61.5% (48/78) of the patients were 40 to 60 years old, and only 12.8% (10/78) were younger than 40 years. Most of the GISs were asymptomatic and found incidentally; others may present non-specific symptoms such as abdominal discomfort or pain, gastrointestinal bleeding, and obstruction ( 3 , 4 , 19 , 26 ). In the present study, 33.3% (26/78) were asymptomatic, and the most common symptom was abdominal pain.…”

“…Currently, most of the studies focused on gastric schwannomas, and few studies reported the GISs in the whole gastrointestinal tract ( 18 , 19 ), and the sample size was relatively small. In the present study, we retrospectively collected and analyzed the clinical data of GISs diagnosed in our hospital to present the clinicopathological characteristics and treatment outcomes of this rare disease.…”