Rare gastric schwannoma presenting with severe gastrointestinal bleeding: A case report

Schwannoma, also known asneurilemmoma or neurinoma, is generally a benign, slow-growing neoplasm that originates from any nerve containing a Schwann cell sheath.These neoplasms are rare among spindle cell mesenchymal tumors of the gastrointestinal tract but most commonly occur in the stomach, accounting for 0.2% of gastric tumors.Gastric schwannoma is a rare tumor, and its presentation with severe gastrointestinal bleeding is even rarer.Diagnosing gastric schwannoma with severe gastrointestinal bleeding poses several challenges, as this tumor is uncommon and its symptoms are often mistaken for other gastrointestinal disorders.In this report, we present a case that highlights the importance of differential diagnosis of such lesions when dealing with gastrointestinal bleeding.The patient was amale 44-year-old with a large gastric schwannoma in the distal stomach.The patient was admitted with severe gastrointestinal bleeding, presenting with Hb = 9 and Hct = 25.3.The patient underwent resuscitation, fluid therapy, and received a total of eight units of blood in two sessions.After stabilization; the patient underwent endoscopy, which revealed a large submucosal lesion and an ulcer with blood in the gastric antrum, though no active bleeding site or vessel was identified.The patient subsequently underwent distal gastrectomy with Billroth I reconstruction.Postoperative immunohistochemical staining of the mass was positive for S100, KI67, and SMA but negative for CD34 and CD117 .The patient was discharged five days postoperatively in satisfactory condition, and the final pathology report confirmed the diagnosis of gastric schwannoma.