Successful treatment of a giant ossified benign mesenteric schwannoma  

作　　者：Ying-Sheng Wu Shao-Yan Xu Jing Jin Ke Sun Zhen-Hua Hu Wei-Lin Wang 

机构地区：[1]Division of Hepatobiliary and Pancreatic Surgery,Department of Surgery,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Province,China [2]Key Laboratory of Combined Multi-Organ Transplantation,Ministry of Public Health,Hangzhou 310003,Zhejiang Province,China [3]Key Laboratory of Organ Transplantation,Hangzhou 310003,Zhejiang Province,China [4]Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province,Hangzhou 310003,Zhejiang Province,China [5]Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Province,China [6]Department of pathology,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Province,China

出　　处：《World Journal of Gastroenterology》2018年第2期303-309,共7页世界胃肠病学杂志（英文版）

基　　金：Supported by the National Natural Science Foundation of China,No.81572307

摘　　要：Primary benign schwannoma of the mesentery is extremely rare. To date, only 9 cases have been reported in the English literature, while mesenteric schwannoma with ossified degeneration has not been reported thus far. In the present study, we present the first giant ossified benign mesenteric schwannoma in a 58-year-old female. Ultrasound, computed tomography and magnetic resonance imaging were used, but it was still difficult to determine the definitive location and diagnose the mass. By laparotomy, a 10.0 cm × 9.0 cm × 9.0 cm giant mass was found in the mesentery and was then completely resected. Microscopically, the tumour located in the mesentery mainly consisted of spindleshaped cells with a palisading arrangement. Some areas of the tumour were ossified, and a true metaplastic bone formation was observed, with the presence of bone lamellae and osteoblasts. Immunohistochemical investigation of the tumour located in the mesentery showed that the staining for the S-100 protein was strongly positive, while the stainings of SMA, CD34, CD117 and DOG-1 were negative. The cell proliferation index, measured with Ki67 staining, was less than 3%. Finally, a giant ossified benign mesenteric schwannoma was diagnosed. After surgery, the patient was followed up for a period of 43 mo, during which she remained well, with no evidence of tumour recurrence.Primary benign schwannoma of the mesentery is extremely rare. To date, only 9 cases have been reported in the English literature, while mesenteric schwannoma with ossified degeneration has not been reported thus far. In the present study, we present the first giant ossified benign mesenteric schwannoma in a 58-year-old female. Ultrasound, computed tomography and magnetic resonance imaging were used, but it was still difficult to determine the definitive location and diagnose the mass. By laparotomy, a 10.0 cm × 9.0 cm × 9.0 cm giant mass was found in the mesentery and was then completely resected. Microscopically, the tumour located in the mesentery mainly consisted of spindleshaped cells with a palisading arrangement. Some areas of the tumour were ossified, and a true metaplastic bone formation was observed, with the presence of bone lamellae and osteoblasts. Immunohistochemical investigation of the tumour located in the mesentery showed that the staining for the S-100 protein was strongly positive, while the stainings of SMA, CD34, CD117 and DOG-1 were negative. The cell proliferation index, measured with Ki67 staining, was less than 3%. Finally, a giant ossified benign mesenteric schwannoma was diagnosed. After surgery, the patient was followed up for a period of 43 mo, during which she remained well, with no evidence of tumour recurrence.

关 键 词：SCHWANNOMA MESENTERY OSSIFICATION LAPAROTOMY S-100 

分 类 号：R57[医药卫生—消化系统]