J Korean Surg Soc.  2011 May;80(5):367-372. 10.4174/jkss.2011.80.5.367.

Isolated primary schwannoma arising on the colon: report of two cases and review of the literature

• Park KJ
• Kim KH
• Roh YH
• Kim SH
• Lee JH
• Rha SH
• Choi HJ

• KMID: 2212163
• DOI: http://doi.org/10.4174/jkss.2011.80.5.367

Abstract

Primary schwannoma of the large intestine is an extremely rare neoplasm. Here, we report two cases of colonic schwannoma confirmed pathologically after laparoscopic resection. A 52-year-old female and a 59-year-old female were referred by their general practitioners to our coloproctologic clinic for further evaluation and management of colonic submucosal masses. Colonoscopies performed in our institution revealed round submucosal tumors with a smooth and intact mucosa in the mid-ascending and descending colon, respectively. Computed tomography (CT) scans showed an enhancing soft tissue mass measuring 2 x 2 cm in the right colon and well-defined soft tissue nodule measuring 1.5 x 1.7 cm in the proximal descending colon, respectively. We performed laparoscopic right hemicolectomy and segmental left colectomy under the preoperative impression of gastrointestinal stromal tumors. Two cases were both diagnosed to be benign schwannoma of the colon after immunohistochemical stains (S-100 (+), smooth muscle actin (-), CD117 (-), and CD34 (-)).

Keyword

Schwannoma; Colon; Immunohistochemical stain

MeSH Terms

Actins
Colectomy
Colon
Colon, Descending
Colonoscopy
Coloring Agents
Female
Gastrointestinal Stromal Tumors
General Practitioners
Humans
Intestine, Large
Middle Aged
Mucous Membrane
Muscle, Smooth
Neurilemmoma
Actins
Coloring Agents

Figure

• 

  Fig. 1 Colonoscopic findings of both cases showing submucosal tumors measuring approximately 2 cm (A) and 1.5 cm (B) in diameter.

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  Fig. 2 Computed tomography scans. (A, B) Images of the first case show a well-defined homogeneously enhancingsubmucosal mass in the posterior wall of the cecum (arrow). (C, D) A well-defined soft tissue nodule can be seen in the proximal descending colon (arrow).

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  Fig. 3 Pathological examinations. (A) Ascending colon shows a well-circumscribed mass, measuring 1.8 × 1.6 cm. The mass is intramurally located and shows whitish fibrotic and firm cut surface without definitive hemorrhage or necrosis. The covering mucosa is intact. (B) The well-circumscribed intramural mass is surrounded by lymphocytic rim (H&E, ×10). (C) The mass is composed of whorled arranged spindle cells and the tumor cells are uniform and show few mitotic figures (H&E, ×100). (D) The tumor shows a diffuse cytoplasmicimmunoreactivity for S-100 protein (×10).

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