A Case Report of Pedunculated Exogastric Neurilemmoma

Suguru Sawada, Takeshi Morimoto, Yasuhiro Kodera, Akihito Torii, Takashi Hirai, Kenzou Yasui, Yoshitaka Yamamura, Tomoyuki Katoh, Tsuyoshi Kitoh

Department of Gastroenterological Surgery, Aichi Cancer Center

A 67-year-old female was admitted for investigation of liver dysfunction. Abdominal ultrasound examination and computed tomography revealed a solid tumor of approximately 4 cm in diameter between the stomach and the liver. Selective celiac angiography revealed a hypervascular mass whose blood flow was supplied by the left gastric artery. An operation was performed in May 1994 under the diagnosis of an exogastric leiomyoma. At laparotomy a pedunculated exogastric tumor was found arising from the lesser curvature of the gastric upper body as a 0.5 cm pedunculus. A wedge resection was performed. Microscopically, hematoxylin-eosin stained sections showed that the tumor consisted of spindle cells arranged in a palisade and the tumor was diagnosed as a neurilemmoma because glial fibrillary acidic protein staining was positive in the tumor cells. According to the literature, only 3 cases of pedunculated exogastric neurilemmoma including ours have been reported in Japan (1974-1995). An exogastric pedunculated configuration is rare. No particular difference was found between these cases and non-pedunculated neurilemmoma. Histopathological diagnosis was reported to be rarely obtained prior to the resection. Wedge resection of the stomach turned out to be adequate therapy for our patient, although a standard treatment regimen for this rare disease has not been established to date.

Key words
pedunculated, exogastric, neurilemmoma

Reprint requests
Suguru Sawada Department of Gastroenterological Surgery, Aichi Cancer Center
1-1 Kanokoden, Chikusaku, Nagoya, 464 JAPAN

Accepted
March 6, 1996

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