Gastric Schwannomas:a Comprehensive Review Of The Literature

Introduction:Schwannomas are rare benign mesenchymal tumours usually affecting females between30and60years old,which originating from any nerve sheath, the tumors account for only0.2%of all gastric neoplasms.Gastrointestinal schwannomas represent only3%of all GI mesenchymal tumors.,which consists mainly of GISTs.Materials and Methods:We report five cases diagnosed by the2nd Affiliated Hospital of Zhejiang University, College of Medicine during2001to2011. All these five cases were diagnosed through pathological examination after abdominal surgery.All the patients were followed up.The literatures were reviewed in the database of Pubmed and Chinese Journal of Science and Technology of VIP.Results:General information:These five patients were all females,with the age between32-54years old,whose average age is46.2years.the exciting cause is not confirmed.Clinical features:The clinical manifestations of the disease are diversified,lack of specificity.In these five cases,two cases presented with epigastric distention and pain,one case got the manifestations of hemorrhage of upper digestive tract,and the other two did not have any discomfort.All the cases had a single lesion,in which three located in greater curvature of the body,two in lesser curvature side.Diagnostic method:We diagnose all the cases through iconography such as sonography, CT scan, gastroscope and histopathology, while all the diagnosis were undetermined, common pathology, immunohistochemisty are the only methods to determine the diagnosis.Treatment and Prognosis:All the patients received surgery,in which three got subtotal gastrectomy,one got wedge resection,and the other one received Laparoscopy-Assisted subtotal Gastrectomy.All the patients were diagnosed definitely through common pathology and immunohistochemisty.Four were benign,and one were proved potential malignant.All the patients were followed up till now and survived and have no discomforts.Conclusion:Gastric Schwannomas are rare benign mesenchymal tumours of the gastrointestinal tract,which has a low definite diagnosis rate. Gastric schwannomas are difficult if not impossible to diagnose preoperatively as clinical presentation,endoscopic and radiologic findings are nonspecific.Most of the tumors are benign. The treatment of choice is complete surgical excision because of diagnostic uncertainty, and the long-term outcome is excellent as these lesions are uniformly benign. Routine histologic analysis and immunohistochemisty are helpful to differentiate gastrointestinal stromal tumors(GISTs) and gastrointestinal leiomyoma,both of which are members of the family of gastrointestinal mesenchymal tumours.Early discovery, early diagnosis and early therapy should be the key to improve the Prognosis of gastric Schwannomas.