Published online Apr 15, 2025. doi: 10.4251/wjgo.v17.i4.102085
Revised: February 5, 2025
Accepted: February 24, 2025
Published online: April 15, 2025
Processing time: 168 Days and 8.8 Hours
Gastric schwannoma (GS) is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter. However, these two types differ significantly in pathology and biological behavior.
To evaluate the computed tomography characteristics of GS and provide insights into its accurate diagnosis.
Twenty-three cases of GS confirmed between January 2011 and December 2023 were assessed clinically and radiologically. Imaging characteristics, including tumor location, size, contour, ulceration, growth pattern, enhancement degree and pattern, cystic change, calcification, and perigastric lymph nodes (PLNs), were reviewed by two experienced radiologists.
Our sample included 18 females and 5 males, with a median age of 54.7 years. A total of 39.1% of cases were asymptomatic. GSs appeared as oval and well-defined submucosal tumors, with exophytic (43.5%) or mixed (endoluminal + exophytic; 43.5%) growth patterns. The tumors were primarily located in the gastric body (78.3%). Ulcerations were observed in 8 cases (34.5%), and PLNs were observed in 15 cases (65%). The average degree of enhancement was 48.3 Hounsfield units. Twenty cases (87%) showed peak enhancement in the delayed phase. Most GSs were ho
GS predominantly showed gradual homogenous enhancement with peak enhancement in the delayed phase. PLNs around GS are helpful in differentiating GS from other gastric submucosal tumors.
Core Tip: This is a retrospective dual-center observational study analyzing the imaging characteristics of gastric schwannoma (GS) and their correlation with Ki-67 expression. GS predominantly occurs in middle-aged women and appears as an oval, well-defined, hypodense submucosal mass with progressive, homogeneous enhancement on contrast-enhanced computed tomography. Enlarged perigastric lymph nodes, confirmed as reactive hyperplasia, are a key distinguishing feature from gastrointestinal stromal tumors. Ki-67 expression remains low, indicating minimal proliferative activity. Although GS is benign, accurate preoperative differentiation from other submucosal tumors is crucial for appropriate management.