A Case Report of Neurinoma of the Cecum

Abstract

We reported a rare case of neurinoma of the cecum. A 55-year-old female who complained of right lower abdominal distention was admitted to our hospital. Physical examination revealed solid and movable tumor, about 30 mm in size, in right lower abdomen without tenderness. Tumor markers, CEA and NSE, were within normal range. Abdominal ultrasonography, CT, MRI, barium enema and colonoscopic examination revealed a submucosal tumor of the cecum that measured 31×28×23 mm. This tumor was slightly hypervascular on angiography and negative on Ga scintigraphy. These findings suggested that this tumor was neurogenic tumor. Since patient had a symptom and the possibility of malignancy could not be excluded, the tumor was removed by a part of cecal resection assisted by laparoscopy. HE histological examination showed that the tumor was composed of fibroblast-like spindle cells and the characteristic of nuclear palisading was observed. Immunohistochemical staining showed that the tumor cells were positive for S-100 protein, NSE, but negative for desmin, smooth muscle actin, CD34. On the basis of HE histological and immunohistochemical findings, a diagnosis of neurinoma was made. We think that immunohistochemical examination is important for differential diagnosis of the neurogenic tumor, myogenic tumor and gastrointestinal stromal tumor (GIST) .