A 29 year old female presenting with a gastric schwannoma: a case presentation and review of the literature

Abstract

Schwannomas or neurilemmoma are benign, slow-growing, encapsulated nerve-sheath tumors arising from Schwann cells.Schwannomas are benign mesenchymal tumors composed of spindle cells and are included in the differential diagnosis along with gastrointestinal stromal tumors (GIST), leiomyomas, and leiomyosarcomas. Schwannomas have a peak incidence in the 4th and 5th decades of life, are slightly more common in females, and represent 0.2% of all gastric tumors and 4% of all benign gastric neoplasms. Since radiographic, endoscopic findings are nonspecific, the diagnosis of schwannoma depends upon immunohistochemical analysis including positive S100 protein and abscence of C-Kit, CD34, and CD 117. GIST has malignant potential thus it is important to distinguish between GIST and schwannoma.The majority of patients with schwannoma remain asymptomatic for extended periods, with most cases discovered incidentally on imaging or laparotomy. We present a case of gastric schwannoma, which is unusual due to the patient’s young age, and the early onset of symptoms of abdominal pain and nausea. Though unusual for young patients, gastric schwannomas should be considered in the differential diagnosis when submucosal gastric masses are detected on preoperative imaging studies. Complete resection with negative margins is the treatment of choice for gastric schwannomas.