[High-Grade Malignant Gastric Schwannoma Curatively Resected by Laparoscopic Distal Gastrectomy with Lymphadenectomy-A Case Report with Review of Literature].

Gastric schwannoma is a rare primary gastric tumor, with several reports of malignancy. We report the case of a 76-year-old woman and conducted a literature review. The patient complained of epigastric pain and was referred to our gastroenterology department by a local doctor. Upper gastrointestinal endoscopy revealed a 30 mm submucosal tumor in the greater curvature of the middle part of the stomach. Endoscopic ultrasound-guided fine-needle aspiration was performed, and immunohistochemical staining confirmed the diagnosis of gastric schwannoma. Abdominal contrast computed tomography revealed the swelling in the surrounding lymph nodes, and fludeoxyglucose F18(FDG)positron emission tomography showed FDG accumulation in the primary lesion. Although biopsy confirmed that the tumor was a schwannoma, not a gastrointestinal tumor or another malignant tumor, laparoscopic radical distal gastrectomy with D2 lymph node dissection was performed. The postoperative course was uneventful, and the patient was discharged on the 10th postoperative day. Histopathological diagnosis showed no lymph node metastasis, but the MIB-1 index was high(10.9%), indicating a diagnosis of high-grade malignant schwannoma. The patient has been undergoing outpatient follow-up for approximately 2 years without recurrence. Gastric schwannoma is a rare primary gastric tumor, and radical surgical procedures should be carefully considered. Further collection and analysis of these cases are necessary in the future.