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.

Keywords: Schwannoma; gastric schwannoma; gastroenterology and hepatology; gastrointestinal stromal tumor; general surgery; laparoscopic wedge resection.

Figure 1.

B-mode ultrasound findings. (a) A hypoechoic mass measuring 5.3 × 4.4 cm was observed in the posterior wall of the stomach. (b) Color Doppler flow imaging showed that the internal blood flow signal was not abundant.

Figure 2.

Computed tomography findings. (a) An oval-shaped mass measuring 5.1 × 4.4 × 5.1 cm was found in the lesser gastric curvature. On plain computed tomography, it exhibited low density. The mass was (b) enhanced in the arterial phase (51 HU) and (c) slightly enhanced in the venous phase (67 HU).

Figure 3.

(a) Laparoscopic imaging. The tumor measured 5 × 4 cm and was rough with a clear margin. (b) The section appeared gray.

Figure 4.

Pathological findings. (a) Pathologic examination revealed that the mass was made of spindle cells. Immunohistochemistry revealed positive staining of (b) S-100 and (c) glial fibrillary acidic protein and negative staining of (d) CD117, (e) CD34, (f) DOG1, (g) desmin, and (h) Ki-67 (magnification, ×100).