Pais Daniela Pato, Andrade Sara, Colaco Ines Bertao, Luis Margarida, Azenha Nuno, Couceiro Ana, Cecilio Jose Valente
Department of Surgery, Hospital Distrital da Figueira da Foz, Rua do Hospital 3094-001, Figueira da Foz, Portugal.
J Med Cases. 2024 Dec;15(12):371-375. doi: 10.14740/jmc4312. Epub 2024 Oct 25.
Gastric schwannomas and gastrointestinal stromal tumors (GISTs) are two types of mesenchymal tumors, which represent a group of rare tumors of the gastrointestinal tract. The differential diagnosis between these two tumors is difficult given their very similar appearance and clinical features. The authors present a case of a 63-year-old man with melena and epigastric pain. An upper digestive endoscopy was performed, revealing an ulcerated gastric subepithelial lesion suspected to be a GIST. Further imaging with a computed tomography (CT) scan revealed a well-defined hypodense solid nodular mass, with homogeneous enhancement, measuring 22 × 18 mm, on the anterior wall of the transition between the body and gastric antrum, situated within the submucosal layer. The patient subsequently underwent a laparoscopic atypical gastrectomy, which proceeded without complications. The pathological examination of the excised lesion confirmed it to be a gastric schwannoma, with complete excision. This case report illustrates a rare cause of gastrointestinal bleeding, that requires immediate action, and resection is usually curative. Given the excellent prognosis after complete resection, a correct diagnosis is essential.
胃神经鞘瘤和胃肠道间质瘤(GISTs)是两种间叶组织肿瘤,它们是一组罕见的胃肠道肿瘤。鉴于这两种肿瘤外观和临床特征非常相似,因此它们之间的鉴别诊断很困难。作者报告了一例63岁男性,有黑便和上腹部疼痛症状。进行了上消化道内镜检查,发现一个溃疡样胃上皮下病变,怀疑是GIST。进一步的计算机断层扫描(CT)显示,在胃体与胃窦交界处前壁的黏膜下层有一个边界清晰的低密度实性结节状肿块,大小为22×18mm,增强均匀。患者随后接受了腹腔镜非典型胃切除术,手术过程无并发症。切除病变的病理检查证实为胃神经鞘瘤,已完全切除。本病例报告说明了一种罕见的胃肠道出血原因,需要立即采取行动,手术切除通常可治愈。鉴于完全切除后预后良好,正确诊断至关重要。