腫瘍圧迫により腸閉塞を呈した巨大胃神経鞘腫の1例

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  • A CASE OF GIANT GASTRIC NEURINOMA WITH MULTIPLE ORGAN FAILURE DUE TO HEMORRHAGIC SHOCK

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A 54-year-old man was admitted to the hospital because of hematemesis. Abdominal CT and US revealed a submucosal tumor of the stomach. He developed M.O.F. due to hemorrhagic shock, and also developed septic shock due to intestinal obstruction on the 13th day. Emergency operation was performed. An infant's head sized tumor with extragastric growth decompressed the superior mesenteric artery and it is because of intestinal obstruction. Wedge resection of the stomach was performed. The resected specimen was 22×17×5cm in size, 1980g in weight, elastic-soft and dark-red polycystic mass.<br> In pathological study it is important to differentiate from leiomyoma. S-100 immuno-histochemical staining was positive and desmin staining was negative. This finding suggested that the tumor was neurogenic. The tumor had encapsulation, palisading of nuclear body and matrix not-stained with alcian blue. This tumor was diagnosed as neurinoma. In post-operative course he recovered from M.O.F.. In this paper an operated case of giant gastric neurinoma was presented here with a review of the literature.

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