Gastric Schwannoma: Differential Diagnosis for a Submucosal Gastric Mass

Gastrointestinal mesenchymal tumours are a group of tumours originating from the mesenchymal stem cells of the gastrointestinal tract, consisting of gastrointestinal stromal tumours (GIST), leiomyomas or leiomyosarcomas and Schwannoma. We report a case of a 45 year old female who came with upper abdominal pain and on preoperative investigations (endoscopy and ultrasonography); a diagnosis of GIST was made. Patient underwent wide local excision of the gastric lesion. Postoperatively, the microscopic examination and immunohistochemistry of the resected specimen revealed as Gastric schwannoma(GS). GSs are generally benign neoplasms with excellent prognosis after surgical resection, whereas 10-30% of GISTs have malignant behaviour. We are reporting this case to highlight the fact that it is important to distinguish GS from GISTs and other submucosal gastric lesions to make an accurate diagnosis to optimally guide treatment options. The importance of immunohistochemistry has also been highlighted.