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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(06): E801-E808
DOI: 10.1055/a-1784-0806
Original article

Natural history of gastrointestinal schwannomas

Amandeep Singh
1   Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States
,
Manik Aggarwal
2   Department of Medicine; Cleveland Clinic, Cleveland, Ohio, United States
,
Pravallika Chadalavada
2   Department of Medicine; Cleveland Clinic, Cleveland, Ohio, United States
,
Mohamed Tausif Siddiqui
2   Department of Medicine; Cleveland Clinic, Cleveland, Ohio, United States
,
Rajat Garg
1   Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States
,
Keith Lai
3   Department of Pathology; Cleveland Clinic, Cleveland, Ohio, United States
,
Prabhleen Chahal
1   Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States
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Endoscopy International Open – recently publishedEndoscopy 2022; 54(07): 731-731
DOI: 10.1055/a-1776-4179

Abstract

Background and study aims Data are lacking on the natural history of gastrointestinal tract schwannomas. We aimed to study the natural history of all gastrointestinal schwannomas including location, diagnosis, management, and long-term outcomes.

Patients and methods Patients with a pathological diagnosis of gastrointestinal schwannoma between January 2000 and March 2020 were identified. Data on baseline demographics, presentations, associated malignancies, malignant transformation, treatment, and recurrence were collected.

Results Our cohort consisted of 44 patients with a mean age of 58.6 years, with 63.6 % women and 84.1 % White. The stomach (38.6 %) was the most common location followed by the colorectum (31.8 %). Only 22.7 % of patients were symptomatic and 22.0 % had a personal history of other malignancies. Tissue diagnosis was obtained via endoscopy in 47.7 % and from surgical pathology in 52.3 %. On histology, 65.9 % of the tumors were solid, 11.4 % had mixed features, and 2.3 % had necrosis. SP100 was tested in all but one patient and was positive in all. Mean Ki-67 in 12 patients with tumors measuring ≥ 2 cm was 3.0 % indicating a low proliferation rate. Of the patients, 77.3 % had surgery and 18.2 % underwent endoscopic resection. At a mean follow-up of 5.0 ± 4.31 years, there was no malignant transformation, recurrence or mortality associated with gastrointestinal schwannomas.

Conclusions Gastrointestinal schwannomas are diagnosed in the fifth to sixth decade with predominance in women and Whites. They are benign, mostly asymptomatic, and diagnosed incidentally. Asymptomatic gastrointestinal schwannomas including lesions ≥ 2 cm in size do not appear to need further monitoring or intervention. Patients with them should be counseled to remain up to date with routine screening guidelines pertaining to the colon, breast, and lung cancer due to the high incidence of concomitant malignancy.



Publication History

Received: 22 September 2021

Accepted: 03 December 2021

Article published online:
10 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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