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Gastric schwannoma: a case report

机译:胃神经鞘瘤:一例报告

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Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic. The preoperative diagnosis via endoscopy is a challenging issue due to the difficulty of differentiation from other submucosal tumors. A 54-year-old woman presented with epigastric pain persisting for the last 10 months. Upper endoscopy revealed an elevated submucosal mass of the gastric antrum. The overlying mucosa was normal. Biopsy specimens yielded only unspecific signs of mild inactive chronic inflammation. Endoscopic ultrasound examination noted a hypoechoic homogeneous mass lesion located in the gastric antrum. The mass appeared to arise from the muscularis propria, and there was no perigastric lymphadenopathy. A contrast-enhanced computed tomography scan identified a homogeneous round mass and arising from the antrum of the stomach. Submucosal tumor was suspected and surgical intervention was recommended. The patient underwent an elective laparoscopic partial gastrectomy. The histopathologic features and immunohistochemical-staining pattern were consistent with a benign gastric schwannoma. Our patient shows no recurrence with a follow-up of one year. The definitive diagnosis of gastric schwannomas requires immunohistochemical studies. Complete margin negative surgical resection, as in this case, is the curative treatment of choice. The clinical course is generally benign.
机译:神经鞘瘤通常是良性的,生长缓慢的肿瘤。它们在胃肠道中很少见,最常见的部位是胃。这些肿瘤通常是无症状的。由于难以与其他粘膜下肿瘤区分开,因此通过内窥镜检查进行术前诊断是一个具有挑战性的问题。一名54岁的女性上腹部疼痛持​​续了最近10个月。上消化道内窥镜检查发现胃窦粘膜下包块增大。上层粘膜正常。活检标本仅产生非特异性的轻度非活动性慢性炎症迹象。内镜超声检查发现位于胃窦的低回声性均匀块状病变。肿块似乎来自固有肌层,并且没有胃周淋巴结肿大。对比增强的计算机断层扫描可以识别出均一的圆形肿块,并由胃窦产生。怀疑粘膜下肿瘤,建议手术治疗。该患者接受了选择性腹腔镜部分胃切除术。组织病理学特征和免疫组化染色模式与良性胃神经鞘瘤一致。我们的患者随访一年没有显示复发。胃神经鞘瘤的明确诊断需要进行免疫组织化学研究。在这种情况下,完全边缘阴性手术切除是治疗的选择。临床过程通常是良性的。

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