Schwannome des Gastrointestinaltraktes

Gastrointestinal schwannomas are extremely rare mesenchymal neoplasms which arise in relation to the gastrointestinal tract.

Epidemiology

They are reported to typically present at about the 3to 5 decades of life .

Clinical presentation

Patients are often asymptomatic but may occasionally present with abdominal discomfort or upper gastrointestinal bleeding from overlying mucosal ulceration.

Pathology

Although they arise from Schwann cells of the gastrointestinal wall neural plexa , they are considered to be distinctively different from the conventional schwannomas that arise in soft tissue or the central nervous system in terms of histological features.

Location

• esophagus (rare; DD leiomyoma)
• stomach: 60-70% of cases (commonest location)
• colon: next commonest location
• rectum

Markers

S100 protein is strongly positive .

Radiographic features

CT

• typically seen as a well-defined, rounded, mural mass(es) with homogeneous attenuation
• tends to lack cystic change and hemorrhage

MRI

Reported features include :

• T1: low or intermediate signal
• T1 C+ (Gd): may demonstrate slow but relative uniform enhancement
• T2: high signal

Treatment and prognosis

They are benign tumors and carries a much better prognosis compared with gastrointestinal stromal tumors.

History and etymology

Initially reported by Daimaru et al. in 1988

Differential diagnoses

• gastrointestinal stromal tumor (GIST)
• gastrointestinal leiomyoma
• gastrointestinal tract neurofibroma

Siehe auch:

• Schwannom
• benigner peripherer Nervenscheidentumor
• Gastrointestinaler Stromatumor
• Schwannom des Ösophagus
• Schwannom des Magens
• Schwannom des Magens einen GIST vortäuschend

und weiter:

• gastrointestinaler Stromatumor des Magens