Mo YK, Chen XP, Hong LL, Hu YR, Lin DY, Xie LC, Dai ZZ. Gastric schwannoma: Computed tomography and perigastric lymph node characteristics. World J Gastrointest Oncol 2025; 17(4): 102085 [DOI: 10.4251/wjgo.v17.i4.102085]
Corresponding Author of This Article
Zhuo-Zhi Dai, PhD, Associate Professor, Department of Radiology, Shantou Central Hospital, No. 114 Waima Road, Shantou 515000, Guangdong Province, China. daistu@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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/
Yong-Kang Mo, Li-Chun Xie, Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515000, Guangdong Province, China
Xia-Pu Chen, Dai-Ying Lin, Zhuo-Zhi Dai, Department of Radiology, Shantou Central Hospital, Shantou 515000, Guangdong Province, China
Liang-Li Hong, Department of Pathology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515000, Guangdong Province, China
Yi-Ru Hu, Clinical Research Center, Shantou Central Hospital, Shantou 515000, Guangdong Province, China
Co-corresponding authors: Li-Chun Xie and Zhuo-Zhi Dai.
Author contributions: Xie LC and Dai ZZ designed the research and provided supervision; Lin DY and Dai ZZ acquired funding; Mo YK and Chen XP collected the samples, analyzed the data, visualized the results, and drafted the original manuscript; Hong LL analyzed the data; Hu YR reviewed and edited the manuscript; All authors have read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82101985.
Institutional review board statement: Ethical approval was obtained from the institutional ethics committees of the First Affiliated Hospital of Shantou University Medical College (No. B-2023-143).
Informed consent statement: The requirement for informed consent was waived by the institutional review board due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data are available from the corresponding authors on reasonable request.
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: Zhuo-Zhi Dai, PhD, Associate Professor, Department of Radiology, Shantou Central Hospital, No. 114 Waima Road, Shantou 515000, Guangdong Province, China. daistu@163.com
Received: October 8, 2024 Revised: February 5, 2025 Accepted: February 24, 2025 Published online: April 15, 2025 Processing time: 168 Days and 8.8 Hours
Abstract
BACKGROUND
Gastric schwannoma (GS) is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter. However, these two types differ significantly in pathology and biological behavior.
AIM
To evaluate the computed tomography characteristics of GS and provide insights into its accurate diagnosis.
METHODS
Twenty-three cases of GS confirmed between January 2011 and December 2023 were assessed clinically and radiologically. Imaging characteristics, including tumor location, size, contour, ulceration, growth pattern, enhancement degree and pattern, cystic change, calcification, and perigastric lymph nodes (PLNs), were reviewed by two experienced radiologists.
RESULTS
Our sample included 18 females and 5 males, with a median age of 54.7 years. A total of 39.1% of cases were asymptomatic. GSs appeared as oval and well-defined submucosal tumors, with exophytic (43.5%) or mixed (endoluminal + exophytic; 43.5%) growth patterns. The tumors were primarily located in the gastric body (78.3%). Ulcerations were observed in 8 cases (34.5%), and PLNs were observed in 15 cases (65%). The average degree of enhancement was 48.3 Hounsfield units. Twenty cases (87%) showed peak enhancement in the delayed phase. Most GSs were homogeneous, while cystic change (13.0%) and calcification (17.4%) were rare.
CONCLUSION
GS predominantly showed gradual homogenous enhancement with peak enhancement in the delayed phase. PLNs around GS are helpful in differentiating GS from other gastric submucosal tumors.
Core Tip: This is a retrospective dual-center observational study analyzing the imaging characteristics of gastric schwannoma (GS) and their correlation with Ki-67 expression. GS predominantly occurs in middle-aged women and appears as an oval, well-defined, hypodense submucosal mass with progressive, homogeneous enhancement on contrast-enhanced computed tomography. Enlarged perigastric lymph nodes, confirmed as reactive hyperplasia, are a key distinguishing feature from gastrointestinal stromal tumors. Ki-67 expression remains low, indicating minimal proliferative activity. Although GS is benign, accurate preoperative differentiation from other submucosal tumors is crucial for appropriate management.
