TRANSVERSE COLON SCHWANNOMA: A CASE REPORT

Case Presentation A 39-year-old woman was referred for a colonoscopy following the identification of an image in the transverse colon during an abdominal contrast-enhanced CT scan. She denied changes in bowel habits, nausea, vomiting, fatigue, or weight loss. Physical abdominal examination revealed no pain, masses, or signs of peritoneal irritation. Proctological and laboratory exams were unremarkable. Colonoscopy identified a nodular, extramucosal lesion in the proximal transverse colon, measuring 30 mm and occupying ¼ of the intestinal lumen. Total abdominal CT suggested a lesion in the proximal transverse colon, indicative of intestinal tuberculosis or gastrointestinal stromal tumor (GIST). The patient underwent a right partial colectomy with D2 lymphadenectomy via laparoscopy. Surgical pathology confirmed a Schwannoma in the colonic wall, measuring 2.5 cm with clear margins. Immunohistochemistry demonstrated diffuse S100 expression, supporting the diagnosis.

Discussion Schwannomas are benign mesenchymal tumors caused by the excessive proliferation of Schwann cells in nerve sheaths. They can occur anywhere in the body, most commonly in the stomach and small intestine, but findings in the transverse colon are extremely rare. These tumors are typically observed between the fifth and eighth decades of life, making this case particularly unique. There remains controversy in the literature regarding the treatment approach for intestinal schwannomas. Several studies suggest the malignant potential of colonic schwannomas is minimal, and pathological parameters, such as mitotic rate and tumor size, appear to have little prognostic significance. Complete surgical resection seems to be the treatment of choice due to the preoperative diagnostic uncertainty and excellent long-term outcomes. Tumor recurrence is generally associated with incomplete surgical margins.

Conclusion This report presents a rare case of intestinal schwannoma and aims to contribute to the scientific community by detailing the evolution and management of the treatment based on updated bibliographical references.

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Publikationsverlauf

Artikel online veröffentlicht:
25. April 2025