Rare presentation of gastric schwannoma: a case report.

Abstract

Schwannomas or neurilemmomas are well-defined benign tumors arising from neural crest cells and surrounding the nerve sheath. These neoplasm’s are rare among the spindle cell mesenchymal tumors of the gastrointestinal tract, and develop most commonly in the stomach representing 0.2% of all gastric tumors. We present a case of 53-years-old female with a history of upper abdominal pain. The physical examination revealed palpable epigastric mass; serum biochemistry and tumor markers were in normal range. Abdominal ultrasound as a first imaging procedure detected 5 cm cystic tumor located between the body and the tail of the pancreas, while upper endoscopy showed sub mucosal mass in the region of cardia. Diagnostic dilemma was resolved by the means of endoscopic ultrasound (EUS), which defined the exact place of the tumor in the gastric wall. Since EUS biopsy was not available procedure, percutaneous biopsy was performed. Histological and immuno-histochemical findings of the biopsy specimen and surgically resected tumor were identical, establishing the diagnosis of schwannoma. Complete surgical resection of the tumor is the treatment of choice, and the prognosis after tumor resection is excellent.