Gastric Schwannoma–Surgery or Endoscopic Treatment?
DOI:
https://doi.org/10.12974/2309-6160.2016.03.1Keywords:
Gastric schwannoma, endoscopy, polypectomy.Abstract
Schwannoma is a tumor formed of spindle cells that arise from the nerve plexus Schwann sheath cells of the gastrointestinal tract wall. It appears to be rare among the tumors of the gastrointestinal tract (GIT) and occurs mainly in the stomach, representing only 0.2% of all cancers of the stomach. It is usually a benign and slow growing tumor, and malignant transformation is very rare. For a long time it may remain clinically silent. Endoscopy of the upper gastrointestinal tract is considered to be the basic diagnostic tool. At this stage, the differential diagnosis is very difficult, based mainly on the exclusion of the presence of GIST (gastrointestinal stromal tumors), which appear more commonly in this location.
This study presents the case of a 44-year-old man with non-specific epigastric pain whose gastroscopy revealed a sub mucosal polyp of the body of stomach which was subsequently removed by endoscopic polypectomy. Based on histopathological and immunohistochemical findings, an Schwannoma Antoni type A was diagnosed.
References
Dudkowiak R, Salomon Ł, Gajecki D, Houdail D, Annabhani A, Hałoń A, et al. Malignant schwannoma of the gastrointestinal tract? Polish Gastroenterology 2012; 19 (4): 179-182.
Charepoo R, Palanisamy AP, Shetty J and Kurtzman SH. A safe and simpler diagnosis of gastric schwannomas. Clinical Case Reports 2015; 3(4): 243-246. https:/doi.org/10.1002/ccr3.215
Alvarez JF and Ben-David K. Gastric Schwannoma: A Rare Find. Journal of Gastrointestinal Surgery 2013; 17(12): 2179-81. https:/doi.org/10.1007/s11605-013-2387-y
Yoon W, Paulson K, Mazzara P, Nagori S, Barawi M and Berri R. Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass. Case Rep Surg 2012; 280982. https:/doi.org/10.1155/2012/280982
Li B, Liang T, Wei L, Ma M, Huang Y, Xu H, et al. Endoscopic interventional treatment for gastric schwannoma: a singlecenter experience. Medicine (Baltimore) 2015; 94(45): e1970.
Shah AS, Rathi PM, Somani VS and Mulani AM. Gastric schwannoma: a benign tumor often misdiagnosed as gastrointestinal stromal tumor. Clin Pract 2015; 5(3): 775. https:/doi.org/10.4081/cp.2015.775
Atmatzidis S, Chatzimavroudis G, Dragoumis D, Tsiaousis P, Patsas A and Atmatzidis K. Gastric schwannoma: a case report and literature review. Hippokratia 2012; 16(3): 280-282.
Hou YY, Tan YS, Xu JF, Wang XN, Lu SH, Ji Y, et al. Schwannoma of the gastrointestinal tract: a clinicopathological, immunohistochemical and ultra structural study of 33 cases. Histopathology 2006; 48(5): 536-45. https:/doi.org/10.1111/j.1365-2559.2006.02370.x
Karabulut N, Martin DR and Yang M. Gastric schwannoma: MRI findings. Br J Radiol 2002; 75: 624-626. https:/doi.org/10.1259/bjr.75.895.750624
Tsai TL, Changchien CS, Hu TH and Hsiaw CM. Demonstration of gastric submucosal lesions by highresolution transabdominal sonography. J Clin Ultrasound 2000; 28: 125-132. https:/doi.org/10.1002/(SICI)1097- 0096(200003/04)28:3<125::AID-JCU4>3.0.CO;2-H
Futagami K, Hata J, Haruma K, Yamashita N, Yoshida S, Tanaka S, et al. Extracorporeal ultrasound is an effective diagnostic alternative to endoscopic ultrasound for gastric sub mucosal tumours. Scand J Gastroenterol 2001; 36(11): 1222-6. https:/doi.org/10.1080/00365520152584888
Wang G, Chen P, Zong L, Shi L and Zhao W. Cellular schwannoma arising from the gastric wall misdiagnosed as a gastric stromal tumor: A case report. Oncol Lett 2014; 7(2): 415-418.