2016 Volume 41 Issue 4 Pages 658-663
The patient was a 79-year-old woman. Submucosal tumor in the upper rectum was decected by colonoscopy as a screening examination for epigastric discomfort.
After 3-year follow-up, the lesion was diagnosed as schwannoma by fine-needle aspiration biopsy. Since the tumor grew with time during the follow-up, she was refered to our department for surgery. Preoperativec colonoscopy showed 25mm submucosal toumor in the upper rectum. Endoscopic ultrasound showed hypoechoic lesion which arose from the 4th layer. FDG-PET CT showed significant accumulation of FDG in the tumor. Laparoscopic low anterior resection with D2 lymph node dissection was performed based on the diagnosis of schwannoma of the rectum.
Histopathological examination revealed that the tumor arose from submucosal to muscular layer which was composed spindle cells arrayed in fascicular fasion. Immunohistopathological staining was positive for S-100 protein and negative for c-kit, CD34 and SMA. The MIB-I positive rate was 10%. The final diagnosis of the tumor was schwannoma of the rectum just as preoperative diagnosis. We here report this case of schwannoma of the rectum which was resected laparoscopically.
