Case Report
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World J Gastroenterol. Jun 7, 2014; 20(21): 6685-6690
Published online Jun 7, 2014. doi: 10.3748/wjg.v20.i21.6685
Solitary schwannoma of the gallbladder: A case report and literature review
Lin-Na Liu, Hui-Xiong Xu, Shu-Guang Zheng, Li-Ping Sun, Le-Hang Guo, Jian Wu
Lin-Na Liu, Hui-Xiong Xu, Shu-Guang Zheng, Li-Ping Sun, Le-Hang Guo, Jian Wu, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tenth People’s Hospital of Tongji University, Shanghai 200072, China
Author contributions: Liu LN and Xu HX designed the report; Sun LP and Guo LH performed the US and CEUS examinations; Liu LN, Zheng SG and Wu J collected the patients’ clinical data; Liu LN and Xu HX wrote the paper.
Supported by Grant from the National Natural Scientific Foundation of China, No. 81301299; Grant from the Shanghai Health and Family Planning Commission, No. 20114003; Grant from the Shanghai Talent Development Project from Shanghai Human Resource and Social Security Bureau, No. 2012045; Grant from the Shanghai Health and Family Planning Commission, No. 2013SY066
Correspondence to: Hui-Xiong Xu, MD, PhD, Professor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tenth People’s Hospital of Tongji University, No. 301, Yanchangzhong Road, Shanghai, 200072, China. xuhuixiong@hotmail.com
Telephone: +86-21-66301031 Fax: +86-21-66301031
Received: November 28, 2013
Revised: March 1, 2014
Accepted: March 12, 2014
Published online: June 7, 2014
Processing time: 190 Days and 2.2 Hours
Abstract

Schwannomas occurring in the gallbladder are extremely rare. Preoperative diagnosis of gallbladder schwannomas appears to be very difficult because they are normally asymptomatic and are often found incidentally. Until now, only five cases have been reported in the literature. To our knowledge, the contrast-enhanced ultrasound (CEUS) features of gallbladder schwannomas have not been reported before in other studies. We treated a 55-year-old male patient with gallbladder schwannoma in China. He had no symptoms, and the lesion was incidentally found by conventional ultrasound (US) when performing a health examination. The patient had normal liver function; moreover, serum carcinoembryonic antigen and alpha-fetoprotein were within the normal ranges. The lesion showed no blood flow signals on color Doppler US, and the wall beneath the lesion was intact on CEUS. The lesion was believed to be a benign entity; in addition, gallbladder adenomyomatosis was suspected. A laparoscopic cholecystectomy was performed to remove the mass. Pathological examination revealed that the tumor was mainly composed of spindle-shaped cells; neither atypical cells nor signs of malignancy were found. Immunohistochemical staining showed a strong positive S-100 protein reaction. Vimentin and CD56 staining were also positive, whereas CD34 and CD117 were negative. Finally, the lesion was diagnosed as schwannoma. Herein, we report the case; the associated literature is also reviewed.

Keywords: Schwannoma; Gallbladder; Ultrasound; Contrast-enhanced ultrasound

Core tip: Gallbladder schwannoma, a benign tumor derived from the Schwann’s cells in the gallbladder wall, is extremely rare. This paper describes the case of a 55-year-old man with a mass in the gallbladder but no other symptoms. The patient was treated by cholecystectomy. After 1 year of follow-up with clinical evaluation and ultrasound (US), it did not show any evidence of local recurrence. We learned through this rare case of gallbladder schwannoma that the imaging findings have not been reported in detail before. The US, especially contrast-enhanced ultrasound, features seemed to be helpful in excluding malignancy, and it was essential for treatment planning and the alleviation of patient anxiety in this case.