Two Cases of Intestional Schwannoma Causing Massive Melena

Kenji Katsumata, Chiaki Tani, Tadashi Nakayama*, Kouichiro Kato, Shinji Hoshino*, Takeo Kubouchi, Mikiya Hayashi, Keiichiro Yamamoto*, Kouzaburo Kimura, Hiromi Serizawa**

The Third Department of Surgery, Tokyo Medical College
*Department of Surgery, Hachiohji Medical Center of Tokyo Medical College
**Department of Pathology, Tokyo Medical Collge

We experienced 2 cases of intestinal schwannoma presenting massive melena. Case 1 was a 48-year-old woman visiting our hospital due to sudden massive melena. Because of the diagnosis of bleeding of the superior mesenteric artery by hemorrhagic scintigraphy, laparotomy was performed, and an extravascular tumor was located about 30 cm from treitz's ligament. This tumor was pathologically diagnosed as Antony A benign schwannoma, although heteromorphic nuclei were observed. Case 2 was a 48-year-old woman visiting our hospital due to abdominal pain and massive melena. On superior mesenteric arteriography, tumor stain was detected in the solid phase. Thus laparotomy was performed under suspicion of intestinal tumor, and a tumor 70 cm from Treitz's ligament was detected. This tumor was pathologically diagnosed as malignant schwannoma due to the presence of karyomitosis. Hemorrhagicscintigraphy and angiography were useful for diagnosis of these cases because of abundant tumor vascularity, and they had histopathologically intersting features.

Key words
massive melena, schwannoma of the small intestine

Reprint requests
Kenji Katsumata Department of Surgery, Hachioji Medical Center of Tokyo Medical College
1163 Tatemachi, Hachioji, 193 JAPAN

Accepted
October 13, 1994

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