Abstract
Objectives Schwannomas are tumors arising from Schwan cells of the neural sheath. Gastrointestinal schwannomas (GS) are rare and easily confused with a heterogeneous group of neuroectodermal or mesenchymal neoplasms. The aim of the present study is to analyze the clinicopathological features, surgical management methods, and long-term prognoses of GS patients. Methods Between August 2004 and July 2019, 51 patients with GS were treated at the Peking Union Medical College Hospital. The medical records were reviewed retrospectively. A database containing demographic characteristics, clinical symptoms, imaging tests, operation details, pathological results, and prognoses was constructed and analyzed. Results GS accounted for 2.0% of all schwannomas. The cohort comprised 19 men (37.3%) and 32 women (62.7%). The mean age was 55.7 ± 11.4 years. The most common symptom was abdominal pain (29.4%). Twenty-seven patients (52.9%) were asymptomatic and diagnosed incidentally. The most common tumor location of GS was the stomach (90.2%). S-100 had the highest positive rate (100%) in immunohistochemical staining. Forty-six patients (90.2%) were followed-up at a mean period of 49.5 ± 41.4 months. Forty-four patients (95.7%) survived without tumor, 1 patient survived with tumor, and 1 patient died. The 5-year cumulative overall survival rate and cumulative disease-free survival rate were 97.5% and 95.2%, respectively. Conclusion GS are rare gastrointestinal tumors with favorable prognoses after surgical resection. Stomach is the most common site. Definitive diagnosis is determined by postoperative pathology. S-100 expression has diagnostic significance.
Highlights
Schwannomas are tumors arising from Schwan cells of the neural sheath [1]
Accurate diagnosis is established by postoperative pathology and immunohistochemistry [2, 6, 9]
A total of 2,529 patients with schwannomas were treated at Peking Union Medical College Hospital between August 2004 and July 2019
Summary
Schwannomas are tumors arising from Schwan cells of the neural sheath [1] They are most commonly found in the central nervous system, spinal cord, and peripheral nerves in the extremities [2]. Gastrointestinal schwannomas (GS), which originate from Auerbach’s nerve plexus in the muscularis propria, are extremely rare [3, 4]. They were first described by Daimaru et al in 1988 [5]. A small number of symptomatic cases can present as bleeding, abdominal pain, a palpable mass, and changes in bowel habits [7, 8]. Accurate diagnosis is established by postoperative pathology and immunohistochemistry [2, 6, 9]
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