A Case Report of Schwannoma of the Ileum Causing Massive Melena

Kiyohiko Shuto, Katsuya Kuga, Nobuyuki Tokumoto, Toru Fukunaga, Hirosato Iwase*

Second Department of Surgery, Chiba University School of Medicine
*Department of Pathology, Kashima Rosai Hospital

A 66-year-o1d woman was admitted to the hospital with sudden melena. Hb was 8.8 g/dl and Ht 27.8%. Blood chemistry and tumor markers were in the normal range. A substantial tumor, measuring 8.5 cm×7.6 cm, was detected in the small intestinein in the pelvic cavity by ultrasonography and computed tomography. Superior mesenteric angiography showed neovascularization over the tumor. Laparotomy was performed on suspicion of leiomyosarcoma of the small intestine. The tumor was located in the ileum 100 cm on the oral side from the end of the ileum without a malignant appearance. A curative operation which included a partial ileum resection was performed involving the extra growing tumor. Histologically the tumor consisted of spindle cells with tubular proloferation and a palisading pattern. Immunological staining of the tumor cells was negative for S-100 protein but positive for NSE. The tumor was a mixed Antoni A and B type of schwannoma of the ileum. Schewannoma of the small intestine is particulary rare. Only 48 cases have been reported in the Japanese literature. We herein report this case with discussion of the relevant literature.

Key words
schwannoma of the small intestine, massive melena

Reprint requests
Kiyohiko Shuto Second Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chuo-ku, Chiba, 260 JAPAN

Accepted
November 15, 1995

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