A CASE OF SCHWANNOMA OF THE STOMACH INTUSSUSCEPTED INTO THE DUODENUM

Abstract

It has been possible to find so many cases of prolapsing gastric polyps and polypoid early gastric cancers reported in Japan so far and prolapse of a polyp from the antrum is not an unusual occurrence on routine X-ray examination. On the other hand, a submucosal tumor of the stomach prolapsed or intussuscepted into the duodenum has been thought to be extremely rare. To the best of our knowledge, 25 cases of prolapsing submucosal tumors have been reported in Japan including 1 personal case (Table 2). In about half of the collected cases the lead tumors originated from upper areas of the stomach, and most cases were old age. This paper presented such a case, and a review was made on the literatures with reference to the clinical aspects, and discussed about the mechanism why nonpeduncu-lated large tumors located in the upper areas of the stomach were capable of prolapsing through the pylorus. The patient, a 74 year-old female, was admitted with complaints of continuous epiga-stric pain accompanied by nausea and postprandial vomiting. Physical examination on admis-sion revealed a tender mass in the epigastrium which was oval in shape and newborn hand in size. Upper GI series and endoscopic examinations revealed a submucosal tumor origin-ating in the body of the stomach intussuscepted into the duodenum with part of the gastric wall (Figure 1-4). Operative specimen (Figure 5) showed a smooth-surfaced oval tumor, 8 x 5.5 x 5.5 cm in size, and weighing 130 g. The tumor was elastic, soft and the mucous membrane was loosely attached to the tumor. Microscopical examination showed the tumor to be a schwannoma (Figure 6).