BACKGROUND Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy,endoscopic ultrasonography,computed tomography(CT)or magnetic resonance imaging.Currently,transabdominal high-resolution ultr...BACKGROUND Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy,endoscopic ultrasonography,computed tomography(CT)or magnetic resonance imaging.Currently,transabdominal high-resolution ultrasound combined with gastrointestinal contrast agent can be used to diagnose stomach tumors effectively and without invasive procedures or radiation.However,although an appreciable number of cases of gastric schwannoma(GS)have been reported since the first description of such in 1988,the ongoing lack of a comprehensive list of ultrasonic characteristics has limited the accuracy of preoperative ultrasound diagnosis.CASE SUMMARY A 64-year-old female patient presented to our hospital with dizziness and head discomfort.During an abdominal ultrasound,a hypoechoic gastric mass was found,having clear and regular boundaries and no observable blood flow.Based on these characteristics,a gastrointestinal stromal tumor was suspected.Results from an endoscopic ultrasound biopsy and accompanying immunohistochemical analysis,coupled with abdominal CT findings indicating lymph node enlargement around the stomach,led to diagnosis of GS but did not exclude malignancy.After surgical resection of the tumor,the final diagnosis of GS without lymph node metastasis was made.No recurrence has occurred in the 6 years of follow-up.CONCLUSION A clearly defined ultrasonic characteristic profile of GS is important to improve diagnostic accuracy.展开更多
BACKGROUND Schwannomas,also known as neurinomas,are benign tumors derived from Schwann cells.Gastrointestinal schwannomas are rare and are most frequently reported in the stomach.They are usually asymptomatic and are ...BACKGROUND Schwannomas,also known as neurinomas,are benign tumors derived from Schwann cells.Gastrointestinal schwannomas are rare and are most frequently reported in the stomach.They are usually asymptomatic and are difficult to diagnose preoperatively;however,endoscopy and imaging modalities can provide beneficial preliminary diagnostic data.There are various surgical options for management.Here,we present a case of a large gastric schwannoma(GS)managed by combined laparoscopic and endoscopic surgery.CASE SUMMARY A 28-year-old woman presented with a 2-mo history of epigastric discomfort and a feeling of abdominal fullness.On upper gastrointestinal endoscopy and endoscopic ultrasonography,a hypoechogenic submucosal mass was detected in the gastric antrum:It emerged from the muscularis propria and projected intraluminally.Computed tomography showed a nodular lesion(4 cm×3.5 cm),which exhibited uniform enhancement,on the gastric antrum wall.Based on these findings,a preliminary diagnosis of gastrointestinal stromal tumor was established,with schwannoma as a differential.Considering the large tumor size,we planned to perform endoscopic resection and to convert to laparoscopic treatment,if necessary.Eventually,the patient underwent combined laparoscopic and gastroscopic surgery.Immunohistochemically,the resected specimen showed positivity for S-100 and negativity for desmin,DOG-1,α-smooth muscle actin,CD34,CD117,and p53.The Ki-67 index was 3%,and a final diagnosis of GS was established.CONCLUSION Combined laparoscopic and endoscopic surgery is a minimally invasive and effective treatment option for large GSs.展开更多
BACKGROUND Schwannomas,also known as neurinomas,are tumors that derive from Schwann cells.Gastrointestinal schwannomas are extremely rare,but the stomach is the most common site.Gastric schwannomas are usually asympto...BACKGROUND Schwannomas,also known as neurinomas,are tumors that derive from Schwann cells.Gastrointestinal schwannomas are extremely rare,but the stomach is the most common site.Gastric schwannomas are usually asymptomatic.Endoscopy and imaging modalities might offer useful preliminary diagnostic information.However,to diagnose schwannoma,the immunohistochemical positivity for S-100 protein is essential,whereas CD117,CD34,SMA,desmin,and DOG-1 are negative.CASE SUMMARY A 45-year-old female was found to have a gastric mass during a medical examination,which was diagnosed as a gastric schwannoma.We performed endoscopic full-thickness resection and endoscopic purse-string suture.Pathology and immunohistochemical staining confirmed the diagnosis of gastric schwannoma through the positivity of S-100 protein.Furthermore,to exclude the misdiagnosis of gastrointestinal stromal tumor,we performed a mutational detection of the c-Kit and PDGFRA genes.Postoperative follow-up revealed that the patient recovered well.CONCLUSION Immunohistochemical staining is essential for the diagnosis of schwannoma.Endoscopic full-thickness resection is an effective treatment method for gastric schwannoma.展开更多
Schwannomas are rarely observed in the gastrointestinal tract.The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia,gastrointestinal bleeding,and an abdominal mass.Many gastric schwannomas a...Schwannomas are rarely observed in the gastrointestinal tract.The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia,gastrointestinal bleeding,and an abdominal mass.Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem.The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein.Wepresent a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a BillrothⅡdistal gastrectomy.In this rare case,the patient had intermittent,colicky abdominal pain,nausea,and vomiting for over 4wk accompanied by a weight loss.A diagnosis of gastric intussusception was made by computed tomography.A BillrothⅡdistal gastrectomy was then performed,and complete en bloc removal(R0 resection)was achieved.Pathology confirmed a gastric schwannoma through positive immunohistochemical staining for S-100 protein.展开更多
基金Supported by the National Natural Science Foundation of China,No.82001819.
文摘BACKGROUND Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy,endoscopic ultrasonography,computed tomography(CT)or magnetic resonance imaging.Currently,transabdominal high-resolution ultrasound combined with gastrointestinal contrast agent can be used to diagnose stomach tumors effectively and without invasive procedures or radiation.However,although an appreciable number of cases of gastric schwannoma(GS)have been reported since the first description of such in 1988,the ongoing lack of a comprehensive list of ultrasonic characteristics has limited the accuracy of preoperative ultrasound diagnosis.CASE SUMMARY A 64-year-old female patient presented to our hospital with dizziness and head discomfort.During an abdominal ultrasound,a hypoechoic gastric mass was found,having clear and regular boundaries and no observable blood flow.Based on these characteristics,a gastrointestinal stromal tumor was suspected.Results from an endoscopic ultrasound biopsy and accompanying immunohistochemical analysis,coupled with abdominal CT findings indicating lymph node enlargement around the stomach,led to diagnosis of GS but did not exclude malignancy.After surgical resection of the tumor,the final diagnosis of GS without lymph node metastasis was made.No recurrence has occurred in the 6 years of follow-up.CONCLUSION A clearly defined ultrasonic characteristic profile of GS is important to improve diagnostic accuracy.
基金Supported by Zhejiang Provincial Natural Science Foundation of China,No. LGF18H160036
文摘BACKGROUND Schwannomas,also known as neurinomas,are benign tumors derived from Schwann cells.Gastrointestinal schwannomas are rare and are most frequently reported in the stomach.They are usually asymptomatic and are difficult to diagnose preoperatively;however,endoscopy and imaging modalities can provide beneficial preliminary diagnostic data.There are various surgical options for management.Here,we present a case of a large gastric schwannoma(GS)managed by combined laparoscopic and endoscopic surgery.CASE SUMMARY A 28-year-old woman presented with a 2-mo history of epigastric discomfort and a feeling of abdominal fullness.On upper gastrointestinal endoscopy and endoscopic ultrasonography,a hypoechogenic submucosal mass was detected in the gastric antrum:It emerged from the muscularis propria and projected intraluminally.Computed tomography showed a nodular lesion(4 cm×3.5 cm),which exhibited uniform enhancement,on the gastric antrum wall.Based on these findings,a preliminary diagnosis of gastrointestinal stromal tumor was established,with schwannoma as a differential.Considering the large tumor size,we planned to perform endoscopic resection and to convert to laparoscopic treatment,if necessary.Eventually,the patient underwent combined laparoscopic and gastroscopic surgery.Immunohistochemically,the resected specimen showed positivity for S-100 and negativity for desmin,DOG-1,α-smooth muscle actin,CD34,CD117,and p53.The Ki-67 index was 3%,and a final diagnosis of GS was established.CONCLUSION Combined laparoscopic and endoscopic surgery is a minimally invasive and effective treatment option for large GSs.
文摘BACKGROUND Schwannomas,also known as neurinomas,are tumors that derive from Schwann cells.Gastrointestinal schwannomas are extremely rare,but the stomach is the most common site.Gastric schwannomas are usually asymptomatic.Endoscopy and imaging modalities might offer useful preliminary diagnostic information.However,to diagnose schwannoma,the immunohistochemical positivity for S-100 protein is essential,whereas CD117,CD34,SMA,desmin,and DOG-1 are negative.CASE SUMMARY A 45-year-old female was found to have a gastric mass during a medical examination,which was diagnosed as a gastric schwannoma.We performed endoscopic full-thickness resection and endoscopic purse-string suture.Pathology and immunohistochemical staining confirmed the diagnosis of gastric schwannoma through the positivity of S-100 protein.Furthermore,to exclude the misdiagnosis of gastrointestinal stromal tumor,we performed a mutational detection of the c-Kit and PDGFRA genes.Postoperative follow-up revealed that the patient recovered well.CONCLUSION Immunohistochemical staining is essential for the diagnosis of schwannoma.Endoscopic full-thickness resection is an effective treatment method for gastric schwannoma.
基金Supported by Department of General Surgery,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai,China
文摘Schwannomas are rarely observed in the gastrointestinal tract.The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia,gastrointestinal bleeding,and an abdominal mass.Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem.The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein.Wepresent a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a BillrothⅡdistal gastrectomy.In this rare case,the patient had intermittent,colicky abdominal pain,nausea,and vomiting for over 4wk accompanied by a weight loss.A diagnosis of gastric intussusception was made by computed tomography.A BillrothⅡdistal gastrectomy was then performed,and complete en bloc removal(R0 resection)was achieved.Pathology confirmed a gastric schwannoma through positive immunohistochemical staining for S-100 protein.
