Gastrointestinal schwannomas are extremely rare mesenchymal neoplasms which arise in relation to the gastrointestinal tract.
They are reported to typically present at about the 3rd to 5th decades of life 4.
Patients are often asymptomatic but may occasionally present with abdominal discomfort or upper gastrointestinal bleeding from overlying mucosal ulceration.
Although they arise from Schwann cells of the gastrointestinal wall neural plexa 4, 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.
- stomach: 60-70% of cases (commonest location)
- colon: next commonest location
S100 protein is strongly positive 1,6.
- typically seen as a well-defined, rounded, mural mass(es) with homogeneous attenuation 2
- tends to lack cystic change and hemorrhage
Reported features include 4:
- 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 1
- 1. Sarlomo-rikala M, Miettinen M. Gastric schwannoma--a clinicopathological analysis of six cases. Histopathology. 1995;27 (4): 355-60. - Pubmed citation
- 2. Levy AD, Quiles AM, Miettinen M et-al. Gastrointestinal schwannomas: CT features with clinicopathologic correlation. AJR Am J Roentgenol. 2005;184 (3): 797-802. AJR Am J Roentgenol (full text) - Pubmed citation
- 3. Vanwijck R, Bafort J, Van steenberge R et-al. Intestinal schwannoma. J Belge Radiol. 1997;80 (6): 316. - Pubmed citation
- 4. Karabulut N, Martin DR, Yang M. Case report: gastric schwannoma: MRI findings. Br J Radiol. 2002;75 (895): 624-6. Br J Radiol (full text) - Pubmed citation
- 5. Fujii Y, Taniguchi N, Hosoya Y et-al. Gastric schwannoma: sonographic findings. J Ultrasound Med. 2004;23 (11): 1527-30. J Ultrasound Med (full text) - Pubmed citation
- 6. Hong HS, Ha HK, Won HJ et-al. Gastric schwannomas: radiological features with endoscopic and pathological correlation. Clin Radiol. 2008;63 (5): 536-42. doi:10.1016/j.crad.2007.05.026 - Pubmed citation