Abstract
A 53 year-old female patient, was admitted to our hospital for the evaluation of severe anemia. After admission, she passed tarry stools. X-ray and endoscopic examination showed an elevated lesion with deep central ulceration its on the anal side of the SDA. The mucous membrane on the foot of the lesion looked normal.These findings strongly suggested leiomyosarcoma. Histological findings of biopsy specimens taken from the surface of the ulceration showed proliferative growth of spindle cells which seemed to originate from the submucosal stromal cells. She was treated surgically by pancreatico-duodenectomy, and the resected specimen looked like a Borrmann type Z tumor, 35×35×10mm in size, in the second portion of the duodenum. Histologically, it revealed Antoni's type A and B schwannoma, and S-100 proteins were stained positively in cytoplasms on immunoperoxidase staining. Moreover, it showed many mitoses and inva-sive growth toward the serous membrane, so it was finally diagnosed as malignant schwannoma of the duodenum. Schwannoma of the duodenum is very rare, and only 15 cases have been reported so far in Japan. The authors discussed the clinical characteristics of duodenal schwannoma based on the 16 cases, including our case and 15 documented cases.
