Gastric schwannoma: a case report and literature review

Abstract

Background Gastric schwannoma is a rarely seen gastric tumor accounting for only 0.2% of all gastric tumors. It is difficult to distinguish a gastric schwannoma from other gastric tumors preoperatively. Case presentation: A 30-year-old man with no significant medical history or physical examination findings presented with a 1-month history of right upper abdominal discomfort. The preoperative diagnosis was a gastrointestinal stromal tumor, but the postoperative pathologic and immunohistochemical examinations confirmed a gastric schwannoma. The patient underwent laparoscopic wedge resection of the stomach without additional postoperative treatment, and his postoperative recovery was uneventful. No recurrence or metastasis was found at the 2-year follow-up examination. Conclusion Although gastric schwannomas are usually not malignant, they are difficult to distinguish from other malignant stromal tumors preoperatively. Surgical resection should be recommended when a schwannoma is malignant or considered to be at risk of becoming malignant.

Incidental finding of a gastric schwannoma: a case report

“…They are commonly misdiagnosed for GIST tumors, which can be malignant in 10–30% of cases [ 5–8 ]. Gastric schwannomas are described as having well-demarcated homogenous density on CT scan [ 9 ]. By contrast, GIST are defined as a heterogeneous enhancing lesion with low attenuation secondary to necrosis or hemorrhage [ 10 ].…”

“…GIST tumors stain positive for CD117 antigen as well as CD34, whereas schwannomas are negative for these markers and positive for S-100. S-100 is a protein derived from neural crest cells and is the most reliable indicator for the diagnosis of a schwannoma [ 9 ]. It is very important to make this distinction prior to surgical intervention since the management of a GIST varies with tumor size and mitotic rate [ 11 ].…”

“…Most of them can be managed with excision of the part of the stomach containing the tumor without lymph node sampling because they rarely metastasize to the lymph nodes [ 9 ]. They are commonly located in the gastric body (59%); however, this tumor was found in the gastric fundus which has been reported to be the location in ~12–18% of gastric schwannomas [ 5 , 6 , 9 ]. This location allowed us to perform a wedge resection of the involved gastric segment, leaving most of the stomach intact.…”

Rare primary malignant peripheral nerve sheath tumor of the left testis: A case report

“…Schwannoma commonly originates from tissues with abundant nerve supply, such as the stomach, ears and parotid glands (7)(8)(9). The most common age of patients with neurilemmomas is 30-50 years.…”

Gastric schwannoma treated by endoscopic full-thickness resection and endoscopic purse-string suture: A case report

“…The stomach is the site with the highest incidence of schwannomas in the gastrointestinal tract[ 3 ]. Gastric schwannomas are typically asymptomatic, and the most common symptoms are stomachache, abdominal mass, and gastrointestinal hemorrhage[ 4 , 5 ].…”