Takemura Masashi, Yoshida Kayo, Takii Mamiko, Sakurai Katsunobu, Kanazawa Akishige
Department of Gastrointestinal Surgery, Osaka City General Hospital, 2-13-22, Miyakojima Hondori, Miyakojima, Osaka City, Osaka, 534-0021, Japan.
J Med Case Rep. 2012 Jan 25;6:37. doi: 10.1186/1752-1947-6-37.
We report a case of gastric malignant schwannoma presenting with gastrointestinal bleeding.
A 70-year-old Japanese man presented with gastrointestinal bleeding to our hospital. Gastrointestinal endoscopy revealed a protruding lesion in the gastric body. Hematoxylin and eosin staining of biopsy specimens from this lesion revealed sheets of spindle cells. Immunohistochemistry revealed that these cells were positive for S-100 protein and negative for c-Kit and smooth muscle actin. Because mitosis was diffusely visible, this tumor was diagnosed as a gastric malignant schwannoma. Distal gastrectomy with lymph node dissection was performed and the patient's postoperative course was uneventful. However, five months after the surgery, he died from multiple liver metastases.
Cases of gastric malignant schwannoma have rarely been reported. The efficacy of surgical resection and postoperative prognosis continues to remain unclear and should be investigated further.
我们报告一例以胃肠道出血为表现的胃恶性施万细胞瘤病例。
一名70岁的日本男性因胃肠道出血到我院就诊。胃肠内镜检查发现胃体部有一突出病变。对该病变活检标本进行苏木精-伊红染色显示成片的梭形细胞。免疫组织化学显示这些细胞S-100蛋白阳性,c-Kit和平滑肌肌动蛋白阴性。由于可见弥漫性核分裂象,该肿瘤被诊断为胃恶性施万细胞瘤。行远端胃切除术及淋巴结清扫术,患者术后恢复顺利。然而,术后五个月,他死于多发肝转移。
胃恶性施万细胞瘤病例报道很少。手术切除的疗效及术后预后仍不明确,应进一步研究。