Yanagawa Senichiro, Kagemoto Kenichi, Tanji Hidehiro, Kodama Shinya, Takeshima Yukio, Sumimoto Kazuo
Department of Surgery, Yoshida General Hospital, Akitakata City, Japan.
Department of Internal Medicine, Yoshida General Hospital, Akitakata City, Japan.
Case Rep Oncol. 2020 Mar 25;13(1):330-335. doi: 10.1159/000506450. eCollection 2020 Jan-Apr.
In general, schwannoma is a benign and slow-glowing neoplasm that rarely occurs in the gastrointestinal tract as a submucosal tumor (SMT), with the most common site being the stomach. As gastric schwannoma (GS) is a rare tumor, there is limited data in the literature about its clinical features. The diagnosis of schwannoma can only be made by pathological examination with positive staining for S-100 protein. It is necessary to obtain an accurate diagnosis to introduce optimal treatment options preoperatively. However, a precise diagnosis of GS is difficult, even with modern imaging techniques. On the other hand, a complete resection with a negative surgical margin (R0) of GS is considered the best treatment, with an excellent prognosis. We present a case of a 66-year-old female patient who underwent laparoscopic-assisted wedge gastrectomy for gastric SMT, pathologically diagnosed as GS, with positive staining for S-100 protein and negative for c-kit and CD34. At 12-month follow-up after surgery, there was no recurrence or metastasis of GS. Our treatment is appropriate and effective in case of GS exceeding 50 mm.
一般来说，施万细胞瘤是一种良性且生长缓慢的肿瘤，很少作为胃肠道黏膜下肿瘤（SMT）出现，最常见的部位是胃。由于胃施万细胞瘤（GS）是一种罕见肿瘤，文献中关于其临床特征的数据有限。施万细胞瘤的诊断只能通过对S - 100蛋白染色呈阳性的病理检查来进行。术前获得准确诊断以引入最佳治疗方案很有必要。然而，即使采用现代成像技术，准确诊断GS也很困难。另一方面，GS的完整切除且手术切缘阴性（R0）被认为是最佳治疗方法，预后良好。我们报告一例66岁女性患者，她因胃SMT接受了腹腔镜辅助楔形胃切除术，病理诊断为GS，S - 100蛋白染色阳性，c - kit和CD34阴性。术后12个月随访，GS无复发或转移。对于直径超过50 mm的GS，我们的治疗方法是合适且有效的。
