Small bud of probable gastrointestinal stromal tumor within a laparoscopically-resected gastric schwannoma

Int J Clin Oncol. 2012 Jun;17(3):294-8. doi: 10.1007/s10147-011-0296-1. Epub 2011 Aug 18.

Abstract

Submucosal tumors (SMTs) of the gastrointestinal (GI) tract can be potentially difficulty to diagnose pathologically. We report a case of a gastric SMT that was resected by laparoscopic partial gastrectomy. Although the initial histological and immunohistochemical examinations considered the tumor as a schwannoma, mRNA-based KIT genotyping indicated that the tumor included cells with KIT gene expression, and that a small number of cells carried a deletion mutation in exon 11. Additional histopathological investigations revealed small aggregates of enlarged spindle to epithelioid cells, which were positive for KIT, CD34 and DOG1, and negative for S-100, scattered among the S-100-positive schwannoma cells. We consider that the cells carrying the KIT gene mutation are microscopic buds of a gastrointestinal stroma tumor (GIST), and to the best of our knowledge, this is the first report of probable GIST tissues identified in a schwannoma. Our observations raised the significance of genotyping for diagnosis of GI tract SMTs.

Publication types

  • Case Reports

MeSH terms

  • Gastrointestinal Neoplasms / pathology*
  • Gastrointestinal Stromal Tumors / pathology*
  • Genotype
  • Humans
  • Middle Aged
  • Mutation
  • Neoplasms, Complex and Mixed / pathology*
  • Neurilemmoma / pathology*
  • Proto-Oncogene Proteins c-kit / genetics
  • Proto-Oncogene Proteins c-kit / metabolism

Substances

  • Proto-Oncogene Proteins c-kit