Gastrointestinal schwannomas are extremely rare mesenchymal neoplasms which arise in relation to the gastrointestinal tract.
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Epidemiology
They are reported to typically present at about the 3rd to 5th decades of life 4.
Clinical presentation
Patients are often asymptomatic but may occasionally present with abdominal discomfort or upper gastrointestinal bleeding from overlying mucosal ulceration.
Pathology
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.
Location
- stomach: 60-70% of cases (commonest location)
- colon: next commonest location
- rectum
Markers
S100 protein is strongly positive 1,6.
Radiographic features
CT
- typically seen as a well-defined, rounded, mural mass(es) with homogeneous attenuation 2
- tends to lack cystic change and hemorrhage
MRI
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
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