Abstract
PurposeTo find differential CT features of colorectal schwannomas from gastrointestinal stromal tumors (GISTs).Materials and MethodsCT features of 13 pathologically proven colorectal schwannomas and 21 GISTs were retrospectively reviewed. The following CT items were analyzed: size, longitudinal and transverse location, shape, margin, homogeneity, necrosis, surface ulceration, calcification, degree of attenuation, the presence of enlarged lymph node (LN), and metastasis. Among the features, significant variables were evaluated using univariate statistical tests. The optimal cut-off point of tumor size was obtained by ROC analysis. Binary logistic regression analysis was used to find the most independent CT variables.ResultsSmall size, non-rectum location, smooth margin, homogeneous high attenuation without necrosis, and the presence of enlarged LNs were found to be significant variables to differentiate schwannomas from GISTs (P<0.05). The optimized cut-off point for tumor size in distinguishing GISTs from schwannomas was 3.9 cm (AUC = 0.808, sensitivity = 66.7%, specificity = 92.3%, P<0.0001). Binary regression analysis revealed that only non-rectum location remained independent predictor for schwannomas differentiated from GISTs (odds ratio = 31.667, P = 0.001).ConclusionColorectal schwannomas usually located in non-rectum and appear as small subepithelial nodules showing homogeneous high attenuation and smooth margin. Schwannomas exclusively accompany with enlarged LNs.
Highlights
Schwannomas are rare tumors that develop from Schwann cells
The optimized cut-off point for tumor size in distinguishing gastrointestinal stromal tumor (GIST) from schwannomas was 3.9 cm (AUC = 0.808, sensitivity = 66.7%, specificity = 92.3%, P
Binary regression analysis revealed that only non-rectum location remained independent predictor for schwannomas differentiated from GISTs
Summary
The colon is the least common site for intestinal involvement and the stomach is the most [1, 2]. The exact prevalence of colonic schwannoma is unclear; it has been indirectly estimated that schwannomas are significantly less common than gastrointestinal stromal tumors (GISTs) by a ratio of 8–100:1 [3, 4]. Colorectal schwannomas have received limited attention from clinicians as well as radiologists due to their rarity. Most colorectal mesenchymal tumors are GISTs; other benign mesenchymal tumors including schwannomas can be found. The exact preoperative differentiation between GIST and schwannoma has clinical significance because colorectal schwannomas are completely benign and totally different from the malignant potential of even small GISTs. to the best of our knowledge there have been no reports addressing this issue
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