Louisiana State University Health Sciences Center Shreveport, LA, United States
Aditya Vyas, MD1, Kabir Husain, DO2, Nazar Hafiz, MD1, Sam Abdehou, MD3, James Morris, MD1, Paul Jordan, FACG1 1Louisiana State University Health Sciences Center, Shreveport, LA; 2LSU Health Shreveport, Shreveport, LA; 3LSUHSC-Shreveport, Shreveport, LA
Introduction: Schwannomas are nerve sheath tumors that originate from Schwann cells. Schwannomas are quite a rare phenomenon in the GI tract as the GI tract is the least frequent location for these kinds of benign lesions. We present a rare case of an asymptomatic individual who was found to have one of these benign lesions during a screening colonoscopy.
Case Description/Methods: A 53 y. o. man with a PMH of HTN with no family history of cancer presented for a screening colonoscopy. He had no complaints or symptoms at the time of presentation. The patient had a 20-pack year smoking history who quit 7 months prior to presentation and drank alcohol only on occasion. During the screening colonoscopy, he was found to have 2 polyps. One polyp was a 12 mm inflammatory, semi-pedunculated polyp in the sigmoid colon that was removed en bloc by a hot snare. The second polyp was a 2 mm sessile, adenomatous-appearing polyp in the sigmoid colon removed with cold biopsy forceps. The pathology indicated the presence of a benign mucosal Schwann cell hamartoma. The patient was called for a follow-up visit and the results of the pathology were discussed at length. A regular follow-up schedule was set up for the outpatient setting.
Discussion: Schwannomas are benign nerve sheath tumors that can be found throughout the body along with the peripheral nervous system. These lesions are known to be of ectodermal origin and are characterized by their slow growth that can transition to malignant lesions if not managed in a timely fashion. Clinicians should be aware of other differentials of submucosal lesions. These differentials can include neuroendocrine tumors, GISTs, leiomyomas, and leiomyosarcomas. The definitive diagnosis is based on the histopathology and immunohistochemistry of the operative specimen. There are a few case reports globally published about the rare occurrences of Schwannomas in the GI tract, and they typically manifest as polypoidal colonic lesions. If the suspicion is high for malignant transformation, treatment options typically include polypectomy or segmental colectomy with negative margins.
Figure: 1a,1b- Endoscopic images of the sigmoid colon polyp 1c- Immunohistochemistry positive for S100 confirming the presence of schwannoma
Disclosures: Aditya Vyas indicated no relevant financial relationships. Kabir Husain indicated no relevant financial relationships. Nazar Hafiz indicated no relevant financial relationships. Sam Abdehou indicated no relevant financial relationships. James Morris indicated no relevant financial relationships. Paul Jordan indicated no relevant financial relationships.
Aditya Vyas, MD1, Kabir Husain, DO2, Nazar Hafiz, MD1, Sam Abdehou, MD3, James Morris, MD1, Paul Jordan, FACG1. P0285 - A Rare Case of Schwannoma Presenting as a Polyp in Sigmoid Colon, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.
