A Case Report of Malignant Schwannoma of the Duodenum

Susumu Eguchi, Koichi Motojima, Satoshi Hashimoto, Yoshifumi Kajiwara, Norihiro Kohara, Tsukasa Tsunoda, Takashi Kanematsu

Second Department of Surgery, Nagasaki University School of Medicine

An 84-year-old woman was admitted with right hypochondralgia. Submucosal tumor in the second portion of the duodenum was identified by various imaging diagnoses, including gastro-intestinal series, computed tomography, endoscopic retrograde cholangio-pancreatography, and angiography. Pancreaticoduodenectomy was performed for the tumor. The resected specimen was 8×7 cm in size, and showed central necrosis and hemorrhage. Microscopically, the tumor was composed of bundles of spindle cells with their nuclei arranged in vague palisade, and was surrounded by lymphocyte infiltration. Finally, this case was diagnosed as schwannoma. Immunohistochemical stainings, including S-100 protein staining, neuron specific enolase (NSE) staining, desmin staining and smooth muscle actin stainig, were negative. High cellularity specific for malignant schwannoma was seen, but mitosis was rare. The patient had liver metastasis 35 months following surgery, and died. To our knowledge, this patient was the fourth case of malignant schwannoma of the duodenum reported in the Japanese literatures.

Key words
malignant schwannoma of the duodenum, S-100 protein staining, liver metastasis of the malignant schwannoma of the duodenum

Reprint requests
Susumu Eguchi Second Department of Surgery, Nagasaki University of Medicine
1-7-1 Sakamoto, Nagasaki, 852 JAPAN

Accepted
October 13, 1993

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