2020 Volume 74 Issue 1 Pages 20-25
An 81-year-old woman was urgently taken to a former hospital because of anorexia. A 60-mm submucosal tumor was found in the rectum, and she was referred to our hospital. A mass was palpated 5 cm from the anal margin by rectal examination. A tumor with a nonuniform contrast effect of 59 × 51 mm in size was found in the lower rectum by contrast-enhanced CT examination, and lymph node enlargement with large axis of less than 12 mm was found around the tumor. An elastic hard submucosal tumor was noted on lower endoscopy. Spindle-shaped cells were observed in the biopsy specimen from the tumor, and were positive for S-100 protein, and negative for c-kit, CD34, SMA, and Desmin, according to immunohistochemistry. Based on the pathological diagnosis, the patient was diagnosed with rectal schwannoma. We performed laparoscopic low anterior resection with lymphadenectomy because lymph node enlargement was noted on the image and malignant cases have been reported. Pathological examination showed schwannomas with no lymph node metastasis or malignant findings. We report this case of rectal schwannoma accompanied by swollen lymph nodes with a review of the literature.
