Clinical Characteristics and Surgical Management of Gastrointestinal Schwannomas

Abstract

Objectives. Schwannomas are tumors arising from Schwan cells of the neural sheath. Gastrointestinal schwannomas (GS) are rare and easily confused with a heterogeneous group of neuroectodermal or mesenchymal neoplasms. The aim of the present study is to analyze the clinicopathological features, surgical management methods, and long-term prognoses of GS patients. Methods. Between August 2004 and July 2019, 51 patients with GS were treated at the Peking Union Medical College Hospital. The medical records were reviewed retrospectively. A database containing demographic characteristics, clinical symptoms, imaging tests, operation details, pathological results, and prognoses was constructed and analyzed. Results. GS accounted for 2.0% of all schwannomas. The cohort comprised 19 men (37.3%) and 32 women (62.7%). The mean age was 55.7±11.4 years. The most common symptom was abdominal pain (29.4%). Twenty-seven patients (52.9%) were asymptomatic and diagnosed incidentally. The most common tumor location of GS was the stomach (90.2%). S-100 had the highest positive rate (100%) in immunohistochemical staining. Forty-six patients (90.2%) were followed-up at a mean period of 49.5±41.4 months. Forty-four patients (95.7%) survived without tumor, 1 patient survived with tumor, and 1 patient died. The 5-year cumulative overall survival rate and cumulative disease-free survival rate were 97.5% and 95.2%, respectively. Conclusion. GS are rare gastrointestinal tumors with favorable prognoses after surgical resection. Stomach is the most common site. Definitive diagnosis is determined by postoperative pathology. S-100 expression has diagnostic significance.

Clinicopathological study of gastric schwannoma and review of related literature

“…According to the literature, the prevalence of GS is one in every 45 patients with GIST [ 5 ]. It has also been reported that GS is more common in female patients aged 40–60, with a male to female ratio of about 1:2 or higher [ 6 ]. The average age of patients in this study was 59 years old, and the male to female ratio was approximately 1:2, which was consistent with the findings of the previous study.…”

Clinical and Molecular Characteristics of Rare Malignant Tumors of Colon and Rectum

“…The prognosis is good because of the predominant benign nature of the tumor. Lymph-nodal involvement and/or hepatic recurrences are observed in very rare colorectal ‘malignant’ schwannomas (better termed as malignant peripheral nerve sheath tumor) [ 33 ]. Notably, colorectal schwannomas are sporadic, not associated with neurofibromatosis I or II (NF1 and NF2).…”

Gastric leiomyoma or gastric schwannoma: a diagnostic dilemma and the role of laparoscopic surgery

“…The appropriate surgical approach depends on tumour location and size, as well as the location of surrounding organs. 7 As these tumours are benign, radiotherapy and chemotherapy are not needed. 2 In 2015, a comprehensive review gathered 137 cases of gastric schwannomas and showed no cases of recurrence after a follow-up period ranging from 1 to 336 months.…”

“…Incomplete margins are the main cause of recurrence. 7 Regular follow-up with CT is not recommended. 6 Contributors FM and LT had the idea of the study.…”