Huge Gastric Schwannoma Characterized by a Gastric Ulcer During Endoscopy

내시경에서 위궤양으로 나타난 거대 위 신경초종 1예

  • Lee, Chang-Jung (Department of Internal Medicine, Daerim Saint Mary's Hospital) ;
  • Park, Suk-Joon (Department of Internal Medicine, Daerim Saint Mary's Hospital) ;
  • Woo, Seong-Yong (Department of Internal Medicine, Daerim Saint Mary's Hospital) ;
  • Oh, Hyun-Jong (Department of Internal Medicine, Daerim Saint Mary's Hospital) ;
  • Sung, Mi-Kyung (Department of Internal Medicine, Daerim Saint Mary's Hospital) ;
  • Lee, Byeong-Ho (Department of Internal Medicine, Daerim Saint Mary's Hospital) ;
  • An, Sung-Bae (Department of Internal Medicine, Daerim Saint Mary's Hospital) ;
  • Yoo, Hyun-Ju (Department Pathology, Daerim Saint Mary's Hospital)
  • Published : 2011.07.30

Abstract

Gastric schwannomas are very rare mesenchymal tumors that can occur throughout the gastrointestinal tract, but are most commonly found in the stomach. The majority of patients have no symptoms, while others may complain of epigastric pain or upper gastrointestinal ulcer bleeding. Endoscopic examination of a gastric schwannoma commonly reveals a protrusive mass, but, as in this case, many types of ulceration can be observed with central necrosis. We report on a 62-year-old woman with endoscopic findings of 1 cm sized necrotizing ulceration and an 11 cm sized submucosal mass on radiological examinations. The patient underwent a wedge-shaped resection of the stomach and segmental resection of the transverse colon. Both histological and immunohistochemical staining revealed a gastric schwannoma.

위 신경초종은 매우 드문 간엽성 종양으로 위장관 중에서 위에 가장 호발 한다. 대부분 무증상이나 일부에서 상복부 동통이나 궤양에 의한 출혈로 나타나며 내시경검사에서는 내강으로 돌출된 형태로 관찰되나 본 증례와 같이 중심부 괴사를 통한 궤양으로 나타나기도 한다. 저자들은 62세 환자가 위내시경 검사에서 1 cm 크기의 괴사성 궤양이 관찰되었고 방사선 검사에서 11 cm 크기의 거대 점막하종양이 발견되어 위 쐐기절제술 및 횡행결장 부분 절제술 치료 후 조직 검사 및 면역조직화학검사에서 거대 위 신경초종으로 최종 진단된 1예를 경험하였기에 보고한다.

Keywords

References

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