Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2018; 24(2): 303-309
Published online Jan 14, 2018. doi: 10.3748/wjg.v24.i2.303
Successful treatment of a giant ossified benign mesenteric schwannoma
Ying-Sheng Wu, Shao-Yan Xu, Jing Jin, Ke Sun, Zhen-Hua Hu, Wei-Lin Wang
Ying-Sheng Wu, Shao-Yan Xu, Jing Jin, Zhen-Hua Hu, Wei-Lin Wang, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Ying-Sheng Wu, Shao-Yan Xu, Jing Jin, Zhen-Hua Hu, Wei-Lin Wang, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Hangzhou 310003, Zhejiang Province, China
Ying-Sheng Wu, Shao-Yan Xu, Jing Jin, Zhen-Hua Hu, Wei-Lin Wang, Key Laboratory of Organ Transplantation, Hangzhou 310003, Zhejiang Province, China
Ying-Sheng Wu, Shao-Yan Xu, Jing Jin, Zhen-Hua Hu, Wei-Lin Wang, Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310003, Zhejiang Province, China
Ying-Sheng Wu, Shao-Yan Xu, Jing Jin, Zhen-Hua Hu, Wei-Lin Wang, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Ke Sun, Department of Pathology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Wu YS and Xu SY contributed equally to this work and should be considered co-first authors; Wu YS, Xu SY and Jing Jin collected case data, prepared the photos and wrote the manuscript; Sun K proofread the pathologic materials; Hu ZH and Wang WL proofread and revised the manuscript; all of the authors approved the final version to be published.
Supported by the National Natural Science Foundation of China, No. 81572307.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wei-Lin Wang, PhD, MD, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun road, Hangzhou 310003, Zhejiang Province, China. wam@zju.edu.cn
Telephone: +86-571-87236466 Fax: +86-571-87236466
Received: August 30, 2017
Peer-review started: August 31, 2017
First decision: September 20, 2017
Revised: October 3, 2017
Accepted: October 26, 2017
Article in press: October 26, 2017
Published online: January 14, 2018
Processing time: 136 Days and 13.4 Hours
Abstract

Primary benign schwannoma of the mesentery is extremely rare. To date, only 9 cases have been reported in the English literature, while mesenteric schwannoma with ossified degeneration has not been reported thus far. In the present study, we present the first giant ossified benign mesenteric schwannoma in a 58-year-old female. Ultrasound, computed tomography and magnetic resonance imaging were used, but it was still difficult to determine the definitive location and diagnose the mass. By laparotomy, a 10.0 cm × 9.0 cm × 9.0 cm giant mass was found in the mesentery and was then completely resected. Microscopically, the tumour located in the mesentery mainly consisted of spindle-shaped cells with a palisading arrangement. Some areas of the tumour were ossified, and a true metaplastic bone formation was observed, with the presence of bone lamellae and osteoblasts. Immunohistochemical investigation of the tumour located in the mesentery showed that the staining for the S-100 protein was strongly positive, while the stainings of SMA, CD34, CD117 and DOG-1 were negative. The cell proliferation index, measured with Ki67 staining, was less than 3%. Finally, a giant ossified benign mesenteric schwannoma was diagnosed. After surgery, the patient was followed up for a period of 43 mo, during which she remained well, with no evidence of tumour recurrence.

Keywords: Schwannoma; Mesentery; Ossification; Laparotomy; S-100

Core tip: To date, only 9 cases of mesenteric schwannomas have been reported in the English literature; an ossified mesenteric schwannoma has not been reported. In the present study, we present the first giant ossified benign mesenteric schwannoma. It was challenging to determine the location and obtain a precise diagnosis of the mesenteric schwannoma prior to surgery. We completely resected the mesenteric schwannoma by laparotomy. In this paper, a literature review was conducted to deepen our understanding of mesenteric schwannomas.