A CASE REPORT OF MALIGNANT SCHWANNOMA OF THE STOMACH

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 60; no. 3; pp. 708 - 714
• Main Authors: ENDO, Shunji, SODA, Shigeo, NEZU, Riichiro, YOSHIKAWA, Yukinobu, MORI, Tadasu, OHSHIMA, Masato
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 1999
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.60.708

A case of malignant schwannoma of the stomach is reported. A 78-year-old-man was admitted to the hospital because of left hypochondriac pain. Physical examination revealed a hard huge mass with tenderness in his left hypochondrium. Upper GI series demonstrated a protuberance in the greater curvature side of the antreior wall of the fornix and the upper corpus. CT scan, magnetic resonance imaging (MRI) and ultrasonography (US) revealed a large solid mass in anterior wall of the corpus compressing the other neighboring organs. Endoscopic US showed the extragastric mass progressing from the forth layer of the stomach wall. Under the diagnosis of leiomyosarcoma of the stomach, an operation was performed. At laparotomy, a large mass with rough surface was found in the greater curvature side of the anterior wall of the fornix. No metastasis was observed. The resected material showed a solid tumor, 19×15×10cm in size, and 1, 600g in weight, with necrotic changes inside. Histologically, it was full of spindle-shaped tumor cells containing atypical nuclei and mitosis. Positive S-100 protein staining and NSE staining, and negative SMA staining suggested that it was neurogenic tumor. These findings indicated malignant schwannoma of the stomach. He has been doing well as of 10 months after the operation without any signs of recurrence. Malignant schwannoma of the stomach is a relatively rare entity and only 25 cases have been reported in Japan. Metastasis has been reported especially in cases of large tumor, therefore careful follow up would be also required for our case.