Abstract
BackgroundSchwannomas originate from Schwann cells, which are constituents of peripheral nerve sheaths, and can occur anywhere in the body at any age. Most occur in soft tissues such as subcutaneous tissues and muscles, occurrence in the abdominal cavity being relatively rare. In particular, schwannomas of the gallbladder are extremely rare. We herein report a rare case of a schwannoma that coexisted with systemic sarcoidosis and presented as a steroid-resistant mass in the gallbladder wall.Case presentationA 40-year-old woman was found to have thickening of the gallbladder wall during a routine medical examination and was referred to our hospital, where she was found to have granular shadows in the lungs; mediastinal, cervical, intraperitoneal, and inguinal lymphadenopathy; parotid gland enlargement; and an erythematous skin rash. She was diagnosed as having systemic sarcoidosis by transbronchial lung biopsy and bronchoalveolar lavage. All her systemic mass lesions except for the one in the gallbladder resolved or became smaller with steroid treatment. The steroid-resistant gallbladder lesion showed enhancement on contrast-enhanced computed tomography and was shown by endoscopic ultrasonography to be a 30-mm-diameter gallbladder wall lesion. We performed laparoscopic cholecystectomy, which resulted in diagnosis of the steroid-resistant tumor as a schwannoma. Five months after surgery, the patient’s prednisolone dosage had been gradually reduced to 5 mg/day and she was doing well with no evidence of recurrence.ConclusionResection of a steroid-resistant tumor resulted in diagnosis of schwannoma, enabling reduction in the patient’s steroid dosage for sarcoidosis.
Highlights
Schwannomas originate from Schwann cells, which are constituents of peripheral nerve sheaths, and can occur anywhere in the body at any age
We report a rare patient with a schwannoma of the gallbladder that coexisted with systemic sarcoidosis and presented as a steroid-resistant mass in the gallbladder wall
Endoscopic ultrasonography (EUS) of the gallbladder lesion showed that the gallbladder lumen was intact and did not identify any mucosal lesions
Summary
Schwannomas originate from Schwann cells, which are constituents of peripheral nerve sheaths, and can occur anywhere in the body at any age [1]. We report a rare patient with a schwannoma of the gallbladder that coexisted with systemic sarcoidosis and presented as a steroid-resistant mass in the gallbladder wall. (2020) 6:76 ultrasonography revealed a hypoechoic mass (30-mm diameter) with no posterior echo enhancement on the abdominal side of the body of the gallbladder (Fig. 1a). Bilateral parotid gland enlargement and enlargement of multiple lymph nodes around the right supraclavicular, mediastinum, lower thoracic para-esophageal, common hepatic artery, and hepatoduodenal ligament were detectable These lymph nodes showed uptake on positron emission tomographycomputed tomography (PET-CT); the gallbladder lesion did not. Our patient was diagnosed as having systemic sarcoidosis by biopsy She was prescribed prednisolone (PSL) 25 mg/day for the systemic sarcoidosis, resulting in complete resolution or reduction in size of all mass lesions except for the gallbladder lesion. The PSL dosage had been gradually reduced to 5 mg/day and the patient was doing well with no evidence of recurrence
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
