PMC4868935_01
a Stomach CT demonstrated a 9.6-cm subepithelial mass with internal necrosis ulcer abutting the gastric lesser curvature. b18F-FDG PET/CT showed a 9.6-cm FDG-avid lesion in the gastric midbody and FDG-avid lymph nodes in the left gastric, aortocaval, left paraaortic and left supraclavicular areas.
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F1
AFP, CA19-9, and CEA were all within normal limits. A contrast-enhanced stomach computerized tomography (CT) scan showed a homogenous exophytic mass measuring 9.6 cm at the lesser curvature of the gastric low body to the antrum with central ulceration abutting the pancreas head (fig. 1a). Fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT (PET/CT) scan showed an obvious FDG-avid lesion measuring 9 cm in the gastric midbody with a high accumulation (maximum standardized uptake value = 7.10) coincident with gastric malignant neoplasm and lymphadenopathy in the left gastric, aortocaval, left paraaortic, and left supraclavicular areas (fig. 1b).
a A 9 cm sized large exophytic mass was clearly identified at the midbody of the lesser curvature of the stomach with lymph node enlargement. b Close-up view of the mass with central ulceration.
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F2
On abdominal exploration, the stomach was mobilized by opening the gastro-hepatic ligament and gastro-colic ligament, and a 9 cm sized large exophytic mass was clearly identified at the midbody of the lesser curvature of the stomach with lymph node enlargement (fig. 2a). The final pathologic report revealed gastric schwannoma located at the midbody of the lesser curvature of the stomach with 8.5 x 7.5 x 5 cm in size, extending from the submucosa to the subserosa (fig. 2b).
Histopathological findings. a Immunohistochemical staining. The spindle tumor cells show a positive reaction for S100 protein. b A cuff-like lymphoid aggregate was recognized around the tumor.
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F3
Up to 3% of tumor cells were positive for Ki-67 (fig. 3a, b).