Matsumoto T, Yamamoto S, Fujita S, Akasu T, Moriya Y
National Cancer Center Hospital, Colorectal Surgery Division, Tokyo, Japan.
Asian J Endosc Surg. 2011 Nov;4(4):178-80. doi: 10.1111/j.1758-5910.2011.00089.x.
Schwannomas of the large intestine are relatively rare. Here, we present a case of schwannoma of the cecum in a 59-year-old woman that was successfully resected by laparoscopic wedge resection. In a medical checkup, a colonoscopy revealed a 2 cm submucosal lesion, without mucosal changes, located in the cecum wall contralateral to Bauhin's valve. Abdominal contrast CT and contrast MRI indicated a smooth-surfaced, semi-round tumor of about 2 cm that gave an enhanced homogeneous signal in the cecum. Laparoscopic wedge resection was performed after the diagnosis of benign submucosal tumor. The lesion was 2.5 × 2.0 cm, was histologically composed of spindle neoplastic cells arranged in cords, was positive for S-100 and vimentin, and was diagnosed as schwannoma. The details of this case are reported herein and focus on the successful application of laparoscopic wedge resection for treatment of the colonic submucosal lesion.
大肠神经鞘瘤相对罕见。在此,我们报告一例59岁女性的盲肠神经鞘瘤,该病例通过腹腔镜楔形切除术成功切除。在一次体检中,结肠镜检查发现一个2厘米的黏膜下病变,无黏膜改变,位于回盲瓣对侧的盲肠壁。腹部增强CT和增强MRI显示一个表面光滑、半圆形、约2厘米大小的肿瘤,在盲肠中呈现均匀强化信号。在诊断为良性黏膜下肿瘤后,进行了腹腔镜楔形切除术。病变大小为2.5×2.0厘米,组织学上由呈束状排列的梭形肿瘤细胞组成,S-100和波形蛋白呈阳性,诊断为神经鞘瘤。本文报告该病例的详细情况,并着重介绍腹腔镜楔形切除术在治疗结肠黏膜下病变中的成功应用。