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Gastric schwannoma.

Ho Young Yoon¹, Choong Bai Kim, Yoon Hee Lee

¹Department of surgery, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.

Yonsei Medical Journal

|December 25, 2008

Summary

This case report details a rare gastric schwannoma, a benign tumor arising from Schwann cells. Diagnosis was confirmed through histopathology and immunohistochemistry, differentiating it from gastrointestinal stromal tumors (GIST).

Area of Science:

Gastroenterology
Surgical Pathology
Oncology

Background:

Schwannomas (neurinomas) are rare, benign, slow-growing neoplasms originating from Schwann cell sheaths.
While they can occur anywhere with nerve tissue, they are uncommon mesenchymal tumors in the gastrointestinal tract.
Gastric schwannomas represent a small fraction (0.2%) of all stomach tumors.

Observation:

A 57-year-old female presented with a large, palpable gastric schwannoma.
The patient underwent subtotal gastrectomy due to suspicion of a gastrointestinal stromal tumor (GIST).

Findings:

Post-operative histopathological examination revealed a fascicular arrangement of spindle cells with characteristic pallisading nuclei.
Immunohistochemical analysis showed positivity for S-100 protein and negativity for smooth muscle actin (SMA).

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These findings definitively confirmed the diagnosis of schwannoma.

Implications:

Accurate diagnosis of gastric schwannoma is crucial for appropriate management.
Distinguishing schwannoma from GIST is essential, as their biological behavior and treatment may differ.
This case highlights the importance of comprehensive histopathological and immunohistochemical evaluation for rare gastric tumors.