Vasilakaki T, Skafida E, Arkoumani E, Grammatoglou X, Tsavari K Koulia A, Myoteri D, Mavromati E, Manoloudaki K, Zisis D
Department of Pathology, Tzaneion General Hospital, Piraeus, Greece.
Case Rep Oncol. 2012 Jan;5(1):164-8. doi: 10.1159/000337689. Epub 2012 Apr 3.
Gastrointestinal schwannomas are uncommon stromal tumors of the intestinal tract and colon schwannomas are extremely rare. We report a rare case of ascending colon schwannoma with associated synchronous adenocarcinoma of the sigmoid colon. A 68-year-old man presented with a 20-day history of bleeding per rectum. Colonoscopy revealed a mass of 4.2 cm in diameter with endoluminal protrusion in the sigmoid colon and a second submucosal tumor in the ascending colon. Surgical intervention was suggested and ileo-hemicolectomy was done. Microscopically, the submucosal tumor of 4 cm in diameter showed features of schwannoma with degenerative change (ancient schwannoma). Lesional cells were positive for S100p and negative for actin, desmin, CD34, CD117, and pankeratin. The mass showed features of an invasive moderately differentiated adenocarcinoma. Colon schwannoma is a rare submucosal tumor, and the incidental occurrence with adenocarcinoma has not been well described in the literature.
胃肠道神经鞘瘤是肠道罕见的间质肿瘤，而结肠神经鞘瘤极为罕见。我们报告一例升结肠神经鞘瘤合并乙状结肠同步腺癌的罕见病例。一名68岁男性，有20天的直肠出血病史。结肠镜检查发现乙状结肠有一个直径4.2 cm、向腔内突出的肿物，升结肠还有一个黏膜下肿瘤。建议手术干预，遂行回肠半结肠切除术。显微镜下，直径4 cm的黏膜下肿瘤表现为伴有退行性改变的神经鞘瘤特征（陈旧性神经鞘瘤）。病变细胞S100p阳性，肌动蛋白、结蛋白、CD34、CD117和全角蛋白阴性。该肿物表现为浸润性中分化腺癌特征。结肠神经鞘瘤是一种罕见的黏膜下肿瘤，其与腺癌的偶然并发在文献中尚未得到充分描述。
