TWO CASES OF SCHWANNOMA OF THE STOMACH

Abstract

Patient 1 was a 70-year-old male. He was found to have a gastric abnormality at a medical checkup. Examinations revealed a submucosal tumor (4×3cm) in the upper gastric corpus. The patient underwent wedge resection of the stomach. Patient 2 was 73-year-old female complaining of vomiting. A submucosal gastric tumor (3×2cm) waS found at the gastric angle. This patient underwent resection of the tumor. Pathological examinations in both patients revealed spindle-shaped cells arranged in palisades. The specimens were positive for S-100 protein. A histological diagnosis of benign schwannoma was made. The medical records of 236 patients with gastric schwannoma reported in the Japanese literature were reviewed. The mean age of the patients was 58.9 years. The male-to-female ratio was 2:3. The most common symptoms included abdominal pain, hematoemesis and bloody stools, and abdominal tumor. S-100 protein was positive in 97% of them. The tumor was successfully diagnosed in only 6% of the patients preoperatively. Operation ranged from tumor enuculeation to extensive gastrectomy. Malignant transformation of the tumor occurred in 15%, and the rate of lymph node metastasis was as low as 1.2%. Because of the benign nature of the tumor, extensive gastrectomy is not always necessary. Selection of an appropriate surgical technique after thorough evaluation of the clinical characteristics of the tumor is important.