What are the other Names for this Condition? (Also known as/Synonyms)

• Gastric Neurilemoma
• Gastric Schwannoma
• Schwann Cell Tumor of Stomach

What is Schwannoma of Stomach? (Definition/Background Information)

• Schwannoma of Stomach is an extremely rare and a mostly benign tumor that arise from the Schwann cells around the nerves; these tumors are essentially nerve sheath tumors
• A schwannoma is seen among a wide range of adults and can occur at various locations in the body. But, the stomach is an uncommon location for the tumor and Gastric Schwannomas are mostly seen in older adults
• Many Schwannoma of Stomach tumors are found incidentally while examining the individual for other medical conditions. The signs and symptoms depend upon the size of the tumors and it may include abdominal pain/discomfort, and blood in stool
• Typically, a surgical excision of Schwannoma of Stomach with its entire removal is the treatment of choice. The prognosis is good with its complete removal in a majority of cases, since it is usually a benign tumor

Who gets Schwannoma of Stomach? (Age and Sex Distribution)

• Schwannoma of Stomach is an uncommon tumor that is usually seen in elderly adults
• Both males and females can be affected
• No specific ethnic or racial preference is seen

What are the Risk Factors for Schwannoma of Stomach? (Predisposing Factors)

Currently, no definitive risk factors are reported for Schwannoma of Stomach that is solitary in nature. However, the following factors are suggested, when multiple schwannoma tumors are found in the body:

• The presence of neurofibromatosis type 2 (NF2), a genetic condition that is characterized by the formation of non-cancerous tumors that affect the nervous system. Approximately 4% of schwannomas are associated with NF2
• A family history of the tumor
• Schwannomatosis: It is a genetic condition that is a usually seen in adults and manifests as multiple schwannomas
• Gorlin-Koutlas syndrome: A complex genetic disorder of multiple tumors in the body including multiple schwannomas
• Trauma: It is often associated with plexiform schwannomas

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes for Schwannoma of Stomach? (Etiology)

The exact cause and mechanism of Schwannoma of Stomach formation is unknown. Schwannomas, in general, are known to be the result of sporadic mutations. This implies that they do not have a preceding family history of the condition.

• Multiple schwannomas are known to occur in a background of genetic disorders, such as neurofibromatosis type 2 (NF2), Gorlin-Koutlas syndrome, or a positive family history
• In general, the tumor is believed to be caused by the overproduction of Schwann cells that wrap around the nerve

What are the Signs and Symptoms for Schwannoma of Stomach?

The signs and symptoms of Schwannoma of Stomach depend on the size of the tumor. In general, small tumors are asymptomatic and large tumors can cause signs and symptoms, which may be caused due to mass effect (presence of bulky tumors).

The signs and symptoms of Gastric Schwannoma may include the following:

• The tumor may be present as a gastric tumor mass and present abdominal pain
• It is often well-defined and demarcated
• The tumors can vary in size from 2 cm to over 10 cm
• Large tumors may ulcerate and bleed
• In such cases, blood in stool may be noted
• Tumors growing to larger sizes can cause compression of adjoining organs and structure, but are not known to infiltrate into them

How is Schwannoma of Stomach Diagnosed?

In many, Schwannoma of Stomach is diagnosed incidentally during imaging studies undertaken for some other medical conditions. The diagnosis may involve the following tests and procedures:

• Complete physical exam with evaluation of medical history
• Ultrasound scan of the stomach/abdomen: It is a non-invasive procedure that uses high frequency sound waves to produce real-time images
• Abdominal CT scan: It is a noninvasive procedure that provides more details of soft tissues, blood vessels, and internal organs
• Stool sample analysis
• Upper GI endoscopy: An endoscopic procedure is performed using an instrument called an endoscope, which consists of a thin tube and a camera. Using this technique, the radiologist can have a thorough examination of the insides of the gastrointestinal tract
• Chromoendoscopy can help detect small-sized tumors; small tumors can also be detected using narrow band imaging technique
• Endoscopic ultrasonography: During this procedure, fine needle aspiration biopsy (FNAB) can be performed on the affected area. This is good technique for tumor detection including tumor invasion parameters, and whether nearby lymph nodes are affected
• Vascular angiographic studies of the tumor
• Exploratory laparoscopy (diagnostic laparoscopy) may be required, if gastrointestinal symptoms are present. In this procedure, the abdomen is examined using a minimally-invasive technique, and a tissue biopsy and tissue for culture obtained

Although the above modalities can be used to make an initial diagnosis, a tissue biopsy of the tumor is necessary to make a definitive diagnosis to begin treatment. The tissue for diagnosis can be procured in multiple different ways which include:

• Fine needle aspiration (FNA) biopsy of the tumor: A FNA biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a FNA biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy is preferred
• Core biopsy of the tumor
• Open biopsy of the tumor

Tissue biopsy:

• A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
• Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
• Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

Note: A differential diagnosis, to eliminate other tumor types may be considered, before arriving at a conclusion.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications for Schwannoma of Stomach?

The complications of Schwannoma of Stomach may include:

• Stress and anxiety due to a concern of stomach cancer
• In rare cases, tumors may recur after surgery
• Damage to the muscles, vital nerves, and blood vessels, during surgery
• Post-surgical infection at the wound site is a potential complication

How is Schwannoma of Stomach Treated?

The treatment options vary from one individual to another. The treatment measures for Schwannoma of Stomach may include the following:

• Majority of asymptomatic tumors are not surgically removed after the tumor is diagnosed and determined to be benign on a biopsy
• The healthcare provider may recommend a ‘wait and watch’ approach for small-sized tumors presenting mild signs and symptoms, after a diagnosis of Gastric Schwannoma is made through a fine needle aspiration or a core biopsy
• Surgical excision and tumor removal is the usual mode of treatment of schwannoma. The tumor may be removed to rule out stomach cancer
• Postoperative care is important: A minimum activity level is ensured, until the surgical wound heals
• Treatment of the underlying or associated conditions, if any present
• Follow-up care with regular screening may be recommended by the healthcare provider

How can Schwannoma of Stomach be Prevented?

Current medical research has not established a method of preventing Schwannoma of Stomach.

• Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus during pregnancy) may help in understanding the risks better during pregnancy
• If there is a family history of the condition, then genetic counseling will help assess risks before planning for a child
• Regular medical screening at periodic intervals with tests and physical examinations are strongly recommended

What is the Prognosis for Schwannoma of Stomach? (Outcomes/Resolutions)

The prognosis of Schwannoma of Stomach depends upon the severity of the signs and symptoms. It also depends upon the overall health of the individual and response to therapy.

• The prognosis of is good, if the tumor can be removed without damaging the underlying nerve. Most schwannomas are benign and do not recur when completely excised
• Also, individuals with small-sized tumors have a better prognosis than those with larger-sized tumors
• If benign schwannomas transform to malignant schwannomas (on very rare occasions), then the prognosis may depend upon a set of several factors including the stage of the tumor, overall health of the individual, and response to therapy

Asymptomatic tumors may require no treatment; unless they cause discomfort, affect the quality of life, or affect functioning of the underlying nerve. In such cases, close monitoring of the tumor is a treatment option.

Additional and Relevant Useful Information for Schwannoma of Stomach:

The following article link will help you understand other cancers and benign tumors:

http://www.dovemed.com/diseases-conditions/cancer/