Sawafta Ahmed, Awashra Ameer, Sawaftah Zaid, Odah Ali Bani, Khatib Amer, Dababat Huthayfa, Yasin Anas, Khamaysa Jehad, Daraghmeh Muath
Department of Medicine, An Najah National University, Nablus P606, Palestine.
Department of Surgery, Tubas Turkish Governmental Hospital, Tubas P480, Palestine.
J Surg Case Rep. 2024 Aug 23;2024(8):rjae525. doi: 10.1093/jscr/rjae525. eCollection 2024 Aug.
Gastric schwannomas are rare, benign neurogenic tumors originating from Schwann cells within the gastrointestinal tract, comprising only 0.2% of all gastric tumors. This report presents the case of a 32-year-old female patient who experienced severe periumbilical pain, nausea, and vomiting, ultimately diagnosed with gastric schwannoma. Initial imaging and endoscopic evaluations suggested a gastrointestinal stromal tumor (GIST), but postoperative histopathological analysis confirmed schwannoma, showing S-100 positivity and negativity for CD117, DOG-1, SMA, Desmin, and CD34. The patient underwent successful central gastrectomy with negative surgical margins and no metastasis. Despite a postoperative complication of small bowel obstruction, which was managed conservatively, the patient remained symptom-free with no recurrence over the follow-up period. This case underscores the importance of differential diagnosis, distinguishing schwannomas from GISTs and other submucosal lesions through thorough histopathological and immunohistochemical analyses, and highlights the efficacy of complete surgical resection in preventing recurrence.
胃神经鞘瘤是一种罕见的良性神经源性肿瘤，起源于胃肠道内的施万细胞，仅占所有胃肿瘤的0.2%。本报告介绍了一名32岁女性患者的病例，该患者经历了严重的脐周疼痛、恶心和呕吐，最终被诊断为胃神经鞘瘤。最初的影像学和内镜评估提示为胃肠道间质瘤（GIST），但术后组织病理学分析证实为神经鞘瘤，显示S-100阳性，而CD117、DOG-1、平滑肌肌动蛋白（SMA）、结蛋白和CD34阴性。患者成功接受了胃中部切除术，手术切缘阴性且无转移。尽管术后出现了小肠梗阻并发症，经保守治疗后，患者在随访期间仍无症状且无复发。该病例强调了鉴别诊断的重要性，即通过全面的组织病理学和免疫组化分析将神经鞘瘤与GIST及其他黏膜下病变区分开来，并突出了完整手术切除在预防复发方面的有效性。
