Endoscopic full-thickness resection of rectal schwannoma: A case report.

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
Ying-Jie Zhang, Meng-Xia Yuan, Wu Wen, Yi Jian, Chuan-Ming Zhang, Jing Yuan, Lin He
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Abstract

Background: Rectal schwannoma (RS) is a rare subtype of schwannoma that presents diagnostic challenges owing to its clinical rarity. The absence of typical symptoms, specific signs, and distinctive radiographic findings often hinders clinicians from reaching a definitive diagnosis before surgical intervention. Herein, we report a case of RS who underwent complete resection through endoscopic full-thickness resection (EFTR) and discuss the clinical, imaging, and pathological features for differential diagnosis.

Case summary: A 71-year-old Chinese woman presented to our outpatient clinic with a 4-year history of a rectal mucosal mass for a follow-up surveillance colonoscopy. A neurogenic tumor with extraluminal growth was considered based on the imaging findings. Resection was required, and an EFTR was performed. On endoscopic exploration, a smooth surface extruding mass was identified at the rectum. The patient was discharged 48 hours after the operation without infection or bleeding. Based on the pathological and immunohistochemical findings of the resected mass, a rectal benign schwannoma was diagnosed. The patient did not undergo any adjuvant therapy. Nearly one year later, a follow-up surveillance colonoscopy and an abdominal and pelvic plain plus enhancement scan were performed, and no tumor recurrence or metastasis was noted.

Conclusion: EFTR is safe and effective for resecting gastrointestinal stromal tumors, especially those with extraluminal growth and no lymph node involvement.

内镜下直肠神经鞘瘤全层切除术1例。
背景:直肠神经鞘瘤(RS)是一种罕见的神经鞘瘤亚型,由于其临床罕见性而呈现诊断挑战。缺乏典型症状、特殊体征和独特的影像学表现往往阻碍临床医生在手术前做出明确的诊断。在此,我们报告一例RS通过内镜全层切除(EFTR)完全切除,并讨论临床,影像学和病理特征,以鉴别诊断。病例总结:一名71岁的中国女性因4年的直肠粘膜肿块病史来到我们的门诊进行随访监测结肠镜检查。根据影像学表现,考虑为腔外生长的神经源性肿瘤。需要切除,并进行EFTR。内窥镜探查,在直肠处发现光滑的表面挤压肿块。术后48小时出院,无感染、出血。根据切除肿块的病理和免疫组织化学结果,诊断为直肠良性神经鞘瘤。患者未接受任何辅助治疗。近一年后,进行了随访监测结肠镜检查和腹部和骨盆平扫加增强扫描,未发现肿瘤复发或转移。结论:EFTR对胃肠道间质瘤的切除安全有效,特别是对腔外生长且不累及淋巴结的肿瘤。
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来源期刊
World Journal of Gastrointestinal Endoscopy
World Journal of Gastrointestinal Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
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