Submucosal Tunnel Endoscopic Resection of a Gastric Schwannoma Mimicking a Submucosal Tumor.
Tiebing Ming, Ling Xiao, Binyang Luo et al.
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Case in brief
A 73-year-old woman with recurrent abdominal distension was found on esophagogastroduodenoscopy to have an 8.2 mm submucosal lesion in the gastric body. Endoscopic ultrasound showed that it arose from the muscularis propria. Submucosal tunnel endoscopic resection was completed without perforation or significant bleeding, preserving the overlying mucosa. Histopathology and immunohistochemistry confirmed a benign schwannoma, with S-100 positivity and CD117 and DOG-1 negativity. She was discharged without complications, and no recurrence was seen at 14-month follow-up.
What made this case unusual
The small gastric schwannoma arose from the muscularis propria and was removed by submucosal tunnel endoscopic resection, rather than traditional surgical resection.
Diagnostic / clinical pearl
For a gastric submucosal lesion, endoscopic ultrasound can define its layer of origin, but histopathology and immunohistochemistry establish schwannoma; this case showed S-100 positivity with CD117 and DOG-1 negativity.
Why it matters
The case illustrates the feasibility of submucosal tunnel endoscopic resection for a carefully selected gastric schwannoma, with no significant bleeding, perforation, postoperative complications, or recurrence at follow-up.