Euanorasetr Chakrapan, Suwanthanma Weerapat
Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2011 Nov;94(11):1399-404.
Gastric schwannoma represent only 0.2% of all gastric tumors and 4% of all benign gastric neoplasms. They are usually asymptomatic but can present with variable symptoms. The authors report a case of a 29-year-old male patient who presented with fever and abdominal pain with epigastric mass. Pre-operative diagnosis was gastric lymphoma with perforation and an abscess formation. Hemigastrectomy with Billroth II anastomosis was performed The pathologic examination and immunohistochemical studies confirmed gastric schawannoma as the diagnosis. The post-operative course was uneventful. Gastric schwannoma are difficult if not impossible to diagnose preoperatively as endoscopic and radiologic findings are nonspecific. The treatment of choice is complete surgical resection because of diagnostic uncertainty and the long-term outcome is excellent. This is the first report of gastric schwannoma presenting with concealed perforation and an abscess formation. The literature was reviewed.
胃神经鞘瘤仅占所有胃肿瘤的0.2%,占所有胃良性肿瘤的4%。它们通常无症状,但也可出现各种症状。作者报告了一例29岁男性患者,该患者表现为发热、腹痛伴上腹部肿块。术前诊断为胃淋巴瘤伴穿孔及脓肿形成。行毕Ⅱ式吻合半胃切除术。病理检查和免疫组化研究确诊为胃神经鞘瘤。术后病程顺利。由于内镜和放射学检查结果不具特异性,胃神经鞘瘤术前很难甚至无法诊断。由于诊断存在不确定性,首选治疗方法是完整手术切除,长期预后良好。这是首例胃神经鞘瘤伴隐匿性穿孔及脓肿形成的报告。并对相关文献进行了综述。