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胃神经鞘瘤:一例报告

Gastric Schwannoma: A Case Report.

作者信息

Romdhane Hayfa, Cheikh Myriam, Mzoughi Zeineb, Slama Sana Ben, Ennaifer Rym, Belhadj Najet

机构信息

Department of Gastroenterology, Mongi Slim University Hospital and University of Tunis El Manar , Tunis, Tunisia.

Department of Visceral Surgery, Mongi Slim Hospital , Sidi Daoued, La Marsa, Tunisia.

出版信息

Clin Pract. 2016 Nov 30;6(4):849. doi: 10.4081/cp.2016.849. eCollection 2016 Oct 24.

Abstract

Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic. The preoperative diagnosis endoscopy is a challenging issue due to the difficulty of differentiation from other submucosal tumors. A 54-year-old woman presented with epigastric pain persisting for the last 10 months. Upper endoscopy revealed an elevated submucosal mass of the gastric antrum. The overlying mucosa was normal. Biopsy specimens yielded only unspecific signs of mild inactive chronic inflammation. Endoscopic ultrasound examination noted a hypoechoic homogeneous mass lesion located in the gastric antrum. The mass appeared to arise from the muscularis propria, and there was no perigastric lymphadenopathy. A contrast-enhanced computed tomography scan identified a homogeneous round mass and arising from the antrum of the stomach. Submucosal tumor was suspected and surgical intervention was recommended. The patient underwent an elective laparoscopic partial gastrectomy. The histopathologic features and immunohistochemical-staining pattern were consistent with a benign gastric schwannoma. Our patient shows no recurrence with a follow-up of one year. The definitive diagnosis of gastric schwannomas requires immunohistochemical studies. Complete margin negative surgical resection, as in this case, is the curative treatment of choice. The clinical course is generally benign.

摘要

施万细胞瘤通常是良性的、生长缓慢的肿瘤。它们在胃肠道中很少见,最常见的部位是胃。这些肿瘤通常无症状。由于难以与其他黏膜下肿瘤鉴别,术前通过内镜诊断是一个具有挑战性的问题。一名54岁女性因上腹部疼痛持续10个月前来就诊。上消化道内镜检查发现胃窦部有一个黏膜下隆起性肿块。其上方黏膜正常。活检标本仅显示轻度非特异性的轻度非活动性慢性炎症迹象。内镜超声检查发现胃窦部有一个低回声均匀肿块病变。该肿块似乎起源于固有肌层,且无胃周淋巴结肿大。增强计算机断层扫描显示胃窦部有一个均匀的圆形肿块。怀疑为黏膜下肿瘤,建议手术干预。患者接受了择期腹腔镜部分胃切除术。组织病理学特征和免疫组化染色模式与良性胃施万细胞瘤一致。我们的患者随访一年无复发。胃施万细胞瘤的确诊需要免疫组化研究。如本例所示,完整切缘阴性的手术切除是首选的治愈性治疗方法。临床病程通常是良性的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42fc/5159778/fccaa43f72c8/cp-2016-4-849-g001.jpg

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