Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2022; 10(5): 1667-1674
Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1667
Gastric schwannoma misdiagnosed as gastrointestinal stromal tumor by ultrasonography before surgery: A case report
Qing-Qing Li, Dong Liu
Qing-Qing Li, Dong Liu, Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Li QQ reviewed the literature and helped draft the manuscript; Liu D revised the manuscript for important intellectual content and analyzed and interpreted the imaging findings; All authors approved the submitted manuscript.
Supported by the National Natural Science Foundation of China, No. 82001819.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Liu, Doctor, PhD, Associate Chief Physician, Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China. winterwenny@126.com
Received: August 26, 2021
Peer-review started: August 26, 2021
First decision: October 22, 2021
Revised: October 31, 2021
Accepted: December 31, 2021
Article in press: December 31, 2021
Published online: February 16, 2022
Processing time: 168 Days and 17.4 Hours
Abstract
BACKGROUND

Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy, endoscopic ultrasonography, computed tomography (CT) or magnetic resonance imaging. Currently, transabdominal high-resolution ultrasound combined with gastrointestinal contrast agent can be used to diagnose stomach tumors effectively and without invasive procedures or radiation. However, although an appreciable number of cases of gastric schwannoma (GS) have been reported since the first description of such in 1988, the ongoing lack of a comprehensive list of ultrasonic characteristics has limited the accuracy of preoperative ultrasound diagnosis.

CASE SUMMARY

A 64-year-old female patient presented to our hospital with dizziness and head discomfort. During an abdominal ultrasound, a hypoechoic gastric mass was found, having clear and regular boundaries and no observable blood flow. Based on these characteristics, a gastrointestinal stromal tumor was suspected. Results from an endoscopic ultrasound biopsy and accompanying immunohistochemical analysis, coupled with abdominal CT findings indicating lymph node enlargement around the stomach, led to diagnosis of GS but did not exclude malignancy. After surgical resection of the tumor, the final diagnosis of GS without lymph node metastasis was made. No recurrence has occurred in the 6 years of follow-up.

CONCLUSION

A clearly defined ultrasonic characteristic profile of GS is important to improve diagnostic accuracy.

Keywords: Gastric schwannoma; Gastrointestinal stromal tumor; Gastrointestinal ultrasound; Endoscopic ultrasonography; Computed tomography; Case report

Core Tip: Gastrointestinal stromal tumor (GIST) is the most common gastrointestinal mesenchymal tumor. Since the concept of gastric schwannoma (GS) was proposed in 1988, the incidence of cases has amassed. Transabdominal high-resolution ultrasound combined with abdominal gastrointestinal contrast agent has a unique advantage in gastrointestinal disease diagnosis as it can effectively diagnose tumors non-invasively without radiation. Although ultrasonographic characteristics of GIST have been reported, the literature lacks series of cases of GS and a clear summary of the ultrasonographic characteristics. A summarized ultrasonographic characteristic profile of GS will improve accuracy of differential diagnosis from to other types of gastrointestinal mesenchymal tumor.