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

Abstract

IntroductionSchwannomas are tumors arising from Schwan cells of the neural sheath, which rarely occur in the gastrointestinal tract. The aim of the present study was to analyze the clinicopathological features and treatment outcomes of gastrointestinal schwannomas (GISs).MethodsPatients who were diagnosed with GISs in our hospital from January 2010 to December 2021 were selected. Data about demographic characteristics, clinical symptoms, treatment methods and outcomes, pathological results, and follow-up results were retrospectively collected and analyzed.ResultsA total of 78 patients with 79 GISs were included, the female-to-male ratio was 55:23, and the average age was 52.12 ± 12.26 years. One-third (26/78) of the patients were asymptomatic. A total of 79 GISs were removed, and the average size was 3.63 ± 2.03 cm (range, 0.3–10 cm). As for tumor location, 54 GISs were located in the stomach, 14 in the esophagus, 2 in the duodenum, 6 in the colorectum (4 in the colon and 2 in the rectum), and the other 3 in the small intestine. A total of 23 and 55 patients underwent endoscopic and surgical resections, respectively. Compared with surgical resection, endoscopic resection is associated with a smaller diameter, lower cost, and shorter hospital stay. Pathological results revealed that S100 was positive in all the GISs. No recurrence was noticed during a median follow-up of 45 months (range, 6–148 months).ConclusionGISs are rare gastrointestinal tumors with favorable prognoses, which are most commonly seen in the stomach and diagnosed by pathological findings with immunohistochemical staining. Surgical resection remains the standard method for removing GISs, while endoscopic resection may serve as an alternative method for selected patients with GISs and may be attempted in GISs with a diameter of <3 cm and no signs of malignancy.

Gastric schwannoma: Two case reports and review of the literature

“…On immunohistochemistry, they are positive for S100 protein, a specific marker for schwannomas in general. Negative expression of other markers, such as cKIT, desmin, and smooth muscle actin (SMA), helps differentiate them from other mesenchymal tumors [ 7 , 8 , 13 , 16 ].…”

“…The therapeutic approach depends on the location, layer of origin, size, and growth pattern of the tumors, as well as their relationship to surrounding structures. Available therapeutic modalities include endoscopic or surgical resection; preoperative imaging evaluation is essential in the decision [ 10 , 13 , 16 ]. Endoscopic or imaging surveillance has been proposed for small (<2 cm) schwannomas, although it is a poor consensus recommendation and rarely adopted in reported cases [1] .…”

Incidental Finding of an Asymptomatic Jejunal Schwannoma: A Rare Case Report and Review of Literature

“… * Nonspecific symptoms include abdominal pain, abdominal distention, abdominal discomfort, vomiting, fatigue, anemia, and gastrointestinal bleeding [ 20 – 23 ]. …”

Differentiating gastric schwannoma from gastric stromal tumor (≤5 cm) by histogram analysis based on iodine-based material decomposition images: a preliminary study

“…One potential explanation is that it may be closely related to the different histopathological structural characteristics of the two groups of tumors. GS rarely shows necrosis and cystic degeneration; its structure is relatively homogeneous, and the contrast-enhanced scan shows a more uniform enhancement pattern (23). In contrast, GST has a high risk of necrosis and cystic degeneration compared to GS, regardless of its size, and the contrast-enhanced scans show a relatively heterogeneous enhancement pattern with a relatively larger variance (3,24).…”