Schwannoma of the rectum: report of a case and review of the literature

Hsu, Kuo–Feng; Lin, Chien-Hua; Wu, Chia-Chang; Hsiao, Cheng–Wen; Lee, T. Y.; M., C.; Jin, Jennifer; Jao, Shu-Wen

doi:10.4321/s1130-01082010000400016

Cited by 10 publications

(6 citation statements)

References 6 publications

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“…In this study, 2 patients with melena had significant decreases in hemoglobin and albumin levels. The CEA and CA 19-9 levels of the studied patients were within the normal range, which was consistent with the findings of previous studies [26, 27]. Notably, one patient had elevated serum NSE levels.…”

Section: Discussionsupporting

confidence: 92%

Intestinal Schwannoma: A Clinicopathological, Immunohistochemical, and Prognostic Study of 9 Cases

Shu

Sun

et al. 2019

Gastroenterology Research and Practice

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Background. Intestinal schwannoma is a type of intestinal interstitial tumor with a very low incidence. At present, there are few studies on intestinal schwannoma. Methods. From January 2010 to January 2018, the patients diagnosed with intestinal schwannoma at the China-Japan Union Hospital of Jilin University were retrospectively reviewed. The patients’ clinicopathological features and prognosis were analyzed. Results. This study enrolled 9 patients with intestinal schwannoma, including 3 males and 6 females. The main symptoms of the patients were abdominal pain and melena. Abdominal computed tomography showed intussusception, slightly high-density shadowing in the intestine, thickening of the intestinal wall, and an intestinal mass. Colonoscopy and endoscopic ultrasonography showed submucosal masses without ulcer formation. Two patients underwent endoscopic biopsy, and the pathological results revealed inflammation and necrosis. One patient had increased neuron-specific enolase (NSE) levels. Immunohistochemical analysis showed that the tumor cells were positive for S-100 and negative for CD117, DOG-1, desmin, and smooth muscle actin. An average of 17 lymph nodes were found around the intestines in 4 patients, all of which demonstrated reactive hyperplasia. No recurrence or metastasis occurred during postoperative follow-up. Conclusions. Intestinal schwannoma is a rare tumor, and in our study its incidence was higher in women than in men. The main symptoms were abdominal pain and melena. Preoperative increases in NSE levels might contribute to a diagnosis. Complete surgical resection with free negative margins is the standard treatment for benign schwannoma. There was no recurrence or metastasis after complete surgical resection, suggesting that follow-up may not be required.

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Section: Discussionsupporting

confidence: 92%

Intestinal Schwannoma: A Clinicopathological, Immunohistochemical, and Prognostic Study of 9 Cases

Shu

Sun

et al. 2019

Gastroenterology Research and Practice

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“… 8,9 Incomplete resection of schwannoma led to unacceptable tumor recurrence rates of 30% locally and 2% in distant organs, meaning that the risk of malignant transformation should not be ignored. 4,10,11 …”

Section: Discussionmentioning

confidence: 99%

Local excision of rectal schwannoma using transanal endoscopic microsurgery: A case report

Suzuki

Suwa

Hada

et al. 2014

International Journal of Surgery Case Reports

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“…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).…”

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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Schwannoma of the rectum: report of a case and review of the literature

Cited by 10 publications

References 6 publications

Intestinal Schwannoma: A Clinicopathological, Immunohistochemical, and Prognostic Study of 9 Cases

Intestinal Schwannoma: A Clinicopathological, Immunohistochemical, and Prognostic Study of 9 Cases

Local excision of rectal schwannoma using transanal endoscopic microsurgery: A case report

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

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