Kumari Sameeta, Saeed Muhammad Ibrahim, Urrehman Adeel
Gastroenterology, Aga Khan University Medical College, Karachi, PAK.
Gastroenterology, Aga Khan University Hospital, Karachi, PAK.
Cureus. 2023 Sep 2;15(9):e44577. doi: 10.7759/cureus.44577. eCollection 2023 Sep.
Gastric schwannomas (GS) are rare, slow-growing, benign subepithelial (SE) lesions of the stomach. These are difficult to differentiate preoperatively from other types of SE lesions, as the gross appearance and clinical presentation are very similar especially the gastrointestinal stromal tumors (GISTs), which are the most common SE lesions of the stomach. We present the case of a 35-year-old Asian man with a one-month history of intermittent, right, upper quadrant pain and hematemesis. Preoperatively, intravenous contrast-enhanced computer tomography scan (CECT) showed a well-circumscribed lesion in the upper abdomen closer to the stomach's lesser curvature. Endoscopic ultrasound revealed an ulcerated subepithelial lesion and subsequent biopsy with a 22-gauge fine-needle biopsy (22G FNB) needle confirmed the diagnosis of GS. The patient underwent distal gastrectomy and a Bilroth 1 procedure. The postoperative biopsy was consistent with the initial one, therefore supporting the diagnosis of gastric schwannoma. Postoperatively, the recovery remained uneventful.
胃神经鞘瘤（GS）是一种罕见的、生长缓慢的胃黏膜下良性病变。由于其大体外观和临床表现与其他类型的黏膜下病变非常相似，尤其是胃肠道间质瘤（GISTs），而胃肠道间质瘤是胃最常见的黏膜下病变，所以术前很难将其与其他类型的黏膜下病变区分开来。我们报告了一例35岁的亚洲男性患者，有1个月间歇性右上腹疼痛和呕血的病史。术前，静脉注射对比增强计算机断层扫描（CECT）显示上腹部有一个边界清晰的病变，靠近胃小弯。内镜超声显示一个溃疡的黏膜下病变，随后用22号细针穿刺活检（22G FNB）针进行活检，确诊为胃神经鞘瘤。患者接受了远端胃切除术和毕罗Ⅰ式手术。术后活检结果与最初的活检结果一致，因此支持胃神经鞘瘤的诊断。术后，恢复过程顺利。
