Surgical endoscopy · 2026
Clinical characteristics and endoscopic management of upper gastrointestinal schwannoma: 12-year experience from a large tertiary hospital in China.
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Xiang Jingyuan, Li Longsong, Xu Ning, Wang Shasha, Linghu Enqiang, Chai Ningli
Аннотация
BACKGROUND AND AIMS: Schwannomas are rarely seen in the upper gastrointestinal tract. The diagnostic and therapeutic strategies for digestive schwannomas have not been studied comprehensively enough. We aimed to investigate the clinical and endoscopic features of upper gastrointestinal schwannomas (UGIS). Additionally, the safety and efficacy of endoscopic resection (ER) for UGIS were evaluated.
METHODS: From March 2013 to June 2025, the patients who underwent ER for UGIS in our center were enrolled. Clinical characteristics, endoscopic ultrasound (EUS) and histopathological results were analyzed retrospectively. The rate of en-bloc resection, complete resection and recurrence were used to evaluate ER outcomes.
RESULTS: In total, 54 patients (36 females, 18 males) were enrolled with a mean age of 51.6 ± 12.8 years. The mean tumor size was 21.7 mm (SD: 10.6 mm). Thirty-nine lesions were located at the gastric body, seven in the gastric antrum, two in the gastric angle and six in the esophagus. Twenty-two patients suffered from digestive symptoms including abdominal pain (11/54, 20.4%), abdominal distention (9/54, 16.7%) and acid reflux (2/54, 3.7%). The endoscopic morphology of UGIS was diverse with a predominance of hemisphere-type (32/54, 59.3%). Under EUS, most tumors presented as hypoechoic lesions (50/54, 92.6%). The rate of en-bloc and complete resection was 88.9% and no local residue or recurrence was observed during a following-up duration of 56.0 ± 39.7 months. Histopathological results revealed all tumors showed positive for S-100. For gastric schwannomas, the occurrence of digestive symptoms was more common in those tumors exhibiting extraluminal growing pattern (extraluminal vs. intraluminal = 14/23 vs. 7/25, P = 0.022).
CONCLUSIONS: UGIS demonstrates characteristic appearance under EUS. Confirmed diagnosis of UGIS depends on immunohistochemistry tests. The occurrence of clinical symptoms in gastric schwannomas might be associated with tumor growing pattern. ER is an effective treatment to manage UGIS with favorable long-term outcomes.
METHODS: From March 2013 to June 2025, the patients who underwent ER for UGIS in our center were enrolled. Clinical characteristics, endoscopic ultrasound (EUS) and histopathological results were analyzed retrospectively. The rate of en-bloc resection, complete resection and recurrence were used to evaluate ER outcomes.
RESULTS: In total, 54 patients (36 females, 18 males) were enrolled with a mean age of 51.6 ± 12.8 years. The mean tumor size was 21.7 mm (SD: 10.6 mm). Thirty-nine lesions were located at the gastric body, seven in the gastric antrum, two in the gastric angle and six in the esophagus. Twenty-two patients suffered from digestive symptoms including abdominal pain (11/54, 20.4%), abdominal distention (9/54, 16.7%) and acid reflux (2/54, 3.7%). The endoscopic morphology of UGIS was diverse with a predominance of hemisphere-type (32/54, 59.3%). Under EUS, most tumors presented as hypoechoic lesions (50/54, 92.6%). The rate of en-bloc and complete resection was 88.9% and no local residue or recurrence was observed during a following-up duration of 56.0 ± 39.7 months. Histopathological results revealed all tumors showed positive for S-100. For gastric schwannomas, the occurrence of digestive symptoms was more common in those tumors exhibiting extraluminal growing pattern (extraluminal vs. intraluminal = 14/23 vs. 7/25, P = 0.022).
CONCLUSIONS: UGIS demonstrates characteristic appearance under EUS. Confirmed diagnosis of UGIS depends on immunohistochemistry tests. The occurrence of clinical symptoms in gastric schwannomas might be associated with tumor growing pattern. ER is an effective treatment to manage UGIS with favorable long-term outcomes.