Ascending Colon Schwannoma Surgically Treated after Accurate Preoperative Diagnosis

Endoscopic full-thickness resection of rectal schwannoma: A case report

BACKGROUND

Rectal schwannoma (RS) is a rare subtype of schwannoma that presents diagnostic challenges owing to its clinical rarity. The absence of typical symptoms, specific signs, and distinctive radiographic findings often hinders clinicians from reaching a definitive diagnosis before surgical intervention. Herein, we report a case of RS who underwent complete resection through endoscopic full-thickness resection (EFTR) and discuss the clinical, imaging, and pathological features for differential diagnosis.

CASE SUMMARY

A 71-year-old Chinese woman presented to our outpatient clinic with a 4-year history of a rectal mucosal mass for a follow-up surveillance colonoscopy. A neurogenic tumor with extraluminal growth was considered based on the imaging findings. Resection was required, and an EFTR was performed. On endoscopic exploration, a smooth surface extruding mass was identified at the rectum. The patient was discharged 48 hours after the operation without infection or bleeding. Based on the pathological and immunohistochemical findings of the resected mass, a rectal benign schwannoma was diagnosed. The patient did not undergo any adjuvant therapy. Nearly one year later, a follow-up surveillance colonoscopy and an abdominal and pelvic plain plus enhancement scan were performed, and no tumor recurrence or metastasis was noted.

CONCLUSION

EFTR is safe and effective for resecting gastrointestinal stromal tumors, especially those with extraluminal growth and no lymph node involvement.

Schwannoma of the colon: a rare submucosal neoplasm

Schwannomas are nerve sheath tumours that can be found throughout the body along peripheral nerves. Primary schwannomas of the colon are very rare. They are usually benign and their surgical resection is considered curative. They are, however, difficult to diagnose preoperatively and therefore tend to be overtreated with major colorectal surgery.

Gastric Schwannoma as an Important and Infrequent Differential Diagnosis of Gastric Mesenchymal Tumours: A Case Report and Review of Literature

The spectrum for gastrointestinal tract mesenchymal tumours includes leiomyomas, leiomyosarcomas, gastrointestinal stromal tumours (GISTs) and schwannomas. Schwannomas (also known as neuroma, neurilemmomas or neurinomas of Verocay) are well-known slow-growing, benign neoplasms that originate from nerve plexuses within a Schwann cell sheath. They can arise anywhere along the course of the peripheral nerve and are frequently reported around the head and neck, brachial plexus and along the gastrointestinal tract. Usually, these tumours are detected as solitary; however, they can occur at multiple sites around the body. Schwannomatosis (multiple schwannomas) is usually associated with neurofibromatosis type 2; the pathogenesis is triggered by mutations of the neurofibromatosis 2 tumour suppressor gene resulting in a loss of its function. Solitary gastric schwannomas are rare lesions that arise from the nerve plexus of the gastric wall. Frequently they are detected incidentally or may present with nonspecific abdominal pain or bleeding. This paper reports the case of a 79-year-old patient diagnosed with gastric schwannoma after presenting with abdominal pain. Gastric schwannomas should be taken into consideration while making a differential diagnosis of lesions that are gastric mesenchymal tumours, which span a broad spectrum. Gastric schwannomas are typically benign, considerably less common than gastric GISTs, and have an excellent prognosis following excision.

Schwannoma of the Rectosigmoid Colon

Schwannoma is a rare tumor in the colon which originates from the peripheral nerve plexus. Most of the cases have been asymptomatic but occasionally present as an obstructive mass. Abdominal investigations are effective in some cases, but usually, they are not informative. A significant number of cases have been detected after their operation by histopathology examination. Immune and histochemical staining shows the spindle cells that have been positive for S-100 and vimentin, but negative for CD34 and smooth muscle actin. If the diagnosis of Schowannoma is confirmed preoperatively, segmental resection is recommended. In this case report, we presented a 58-year-old woman with pelvic mass and normal colonoscopy that mimic extramural large uterine myoma with extraluminal pressure effect on the rectosigmoid.