Abstract:

Objective To investigate the clinicopathologic features, diagnosis and differential diagnosis of gastric schwannoma (GS), and to summarize the treatment experience and prognosis. Methods The clinical data of 12 cases of GS were analysed. The pathological features, immunohistochemical characteristics,surgical management and follow-up data were evaluated. Results The tumors located in the gastric antrum in 3 cases, in the gastric body in 8 cases and in the gastric fundus in 1 case. The tumors grew to the cavity in 7 cases, and grew outside to the cavity in 5 cases. Serum CEA increased in 1 patient with GS and gastric cancer before operation, and serum CEA and CA199 increased in another patient with GS. All tumors cells were spindle under microscope. Immunohistochemical detection revealed that GS tumor cells were positive for S-100 protein and Vimentin protein in all cases, and were weakly positive for CD34 in 2 cases. Molecular biological detection in 4 patients indicated that exon 9,11,13 and 17 of C-kit gene and exon 12 and 18 of PDGFRA gene were wild type, with no gene mutations. No tumor recurrence or metastasis occurred in the 9 cases with follow-up except that one patient with GS and gastric cancer died of recurrence of gastric cancer. Conclusion The diagnosis of GS depends on pathological and immunohistochemical examinations. S-100 is an important marker for the diagnosis of GS. Preoperative gastroscopic and imaging CT examinations can provide clues to the diagnosis. Surgical en bloc resection is necessary for the treatment of GS, and minimally invasive surgery can be used as the first choice of operation for GS.

Key words: gastric Schwannoma, clinicopathological features, immunohistochenistry, prognosis