A Case Report of a Gastric Schwannoma on the Lesser Curvature of the Stomach Presenting with Upper Gastrointestinal Bleeding

Matthew Hager^1, and Joey Jarrard¹

¹Department of Surgery, Florida State University College of Medicine, Tallahassee, FL, USA

Cite this paper

Matthew Hager and Joey Jarrard. A Case Report of a Gastric Schwannoma on the Lesser Curvature of the Stomach Presenting with Upper Gastrointestinal Bleeding. American Journal of Medical Case Reports. 2019; 7(3):33-35. doi: 10.12691/AJMCR-7-3-1

Abstract

Introduction: Gastric schwannomas are extremely rare mesenchymal tumors that represent only 0.2% of all gastric neoplasms. These tumors arise from the Auerbach or Meissner’s plexus and are most commonly found incidentally. Of those presenting with a gastric schwannoma only 12.8% of patients will present with upper gastrointestinal bleeding. Case Presentation: In this report, we present the case of a 51 year old female with signs and symptoms of upper gastrointestinal bleeding from a gastric schwannoma. The patient’s computed tomography revealed a 6.4 x 5.7 cm mass on the lesser curvature of the stomach near the pylorus. She subsequently underwent esophagogastroduodenoscopy with endoscopic ultrasound and fine needle aspiration revealing SMMS-1, Pankeratin, CD34, DOG-1, and CD117 negative immunohistochemical stains, which suggested a spindle cell neoplasm. The patient’s tumor was surgically resected two weeks later via laparoscopic distal gastrectomy with gastrojejunostomy. On immunohistochemistry, the tumor stained positive for S100, suggesting a gastric schwannoma. The patient’s postoperative course was complicated by possible early dumping syndrome which resolved in one week with dietary changes. She is tolerating regular food on follow-up and doing well. Discussion: With only a handful of reported cases, the need for inclusion of gastric schwannomas to the differential diagnosis of a bleeding gastric mass is essential. From these figures the likelihood of a patient with a gastric mass and upper gastrointestinal bleeding being caused by a gastric schwannoma is 0.026%. This points to the fact that this patient presentation is extremely rare but that gastric schwannomas do occur and need to be on the differential diagnosis of a patient with a gastric mass and signs of upper gastrointestinal bleeding.

Keywords

gastric schwannoma, S100, upper gastrointestinal bleeding, gastric tumor, gastric neoplasm

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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