胃神经鞘瘤1例报道并文献复习

Gastric achwannoma： one case report and literature review

目的分析胃神经鞘瘤的发病概况、临床表现、诊断和治疗。方法回顾性分析近10年核心期刊所报告的61例胃神经鞘瘤患者的临床病例并结合文献复习。结果本文共统计61例，男31例，女30例，确诊年龄10至75岁，有确切年龄统计的40例，病例中位年龄57岁。因上腹部疼痛或不适就诊者共48例，占78．7％；因呕血或黑便就诊者共38例，占62．2％；因发现腹部肿块就诊者14例，占23．0％。肿块生长于胃体28例，占45．9％；胃底18例，占29.5％；胃窦11例，占18．0％；幽门管1例，占1．6％；胃体与胃底交界处1例，1．6％；胃体与胃窦交界处1例，占1．6％，其中恶性4例。所有病例均经免疫组化确诊，无依据影像学及临床表现确诊者。所有病例均经手术治疗，良性者无复发病例报告，恶性者预后差。结论胃神经鞘瘤多发于中老年人，绝大多数属于良性，病程较长，多因上腹部各种症状就诊。术前诊断困难，活检是唯一的确诊方法，良恶性均需手术治疗。本例患者发病年龄小（仅10岁），发病部位特殊（幽门管），实属罕见。

Objective To analyze gastric achwannoma morbidity overview, clinical situation, diagnosis and therapy. Methods Gastric achwannoma reported in core journal decade were reviewed. Results There were 61 cases, male 31, female 30,aged from 10 to 75 years old. forty patients were precisely statisticed . Those neutral age was 57 years. 48 client with epigastric zone pain or unwell, occupy 78.7% ; 38 client with hematemesis or melena,occupy 62.2% ; 14 client with abdominal mass,occupy 23.0%. 28 patients＇ tumor grew in the body of stomach,occupy 45.9%; 18 cases grew in the fundus of stomach, occupy 29.5% ： 11 cases sinus ventriculi, 18.0%. 1 cases pyloric canal, 1.6% ; 1 cases grew in the juncture of body and fundus of stomach,occupy 1.6% ;1 case grew the junction of body and sinus ventriculi, 1.6%. 4 cases were malignant of the total. All cases were finally diagnosed by immunohistochemistry, undenpendable of imageology and clinical situation. All cases were treated through operation. Innocuousness without postoperative recurrence. Malignant patients had bad prognosis. Conclusion Most of gastric achwannoma were middle or old age, innocuousness, long course, and mostly client visited because of epigastric symptoms. Preoperative diagnosis was difficult, biopsy was the unique final diagnosis method. Despite of innocuousness or malignant, all cases need operation treatment.