Gastric schwannoma misdiagnosed as gastrointestinal stromal tumor by ultrasonography before surgery: A case report

BACKGROUND Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy, endoscopic ultrasonography, computed tomography (CT) or magnetic resonance imaging. Currently, transabdominal high-resolution ultrasound combined with gastrointestinal contrast agent can be used to diagnose stomach tumors effectively and without invasive procedures or radiation. However, although an appreciable number of cases of gastric schwannoma (GS) have been reported since the first description of such in 1988, the ongoing lack of a comprehensive list of ultrasonic characteristics has limited the accuracy of preoperative ultrasound diagnosis. CASE SUMMARY A 64-year-old female patient presented to our hospital with dizziness and head discomfort. During an abdominal ultrasound, a hypoechoic gastric mass was found, having clear and regular boundaries and no observable blood flow. Based on these characteristics, a gastrointestinal stromal tumor was suspected. Results from an endoscopic ultrasound biopsy and accompanying immunohistochemical analysis, coupled with abdominal CT findings indicating lymph node enlargement around the stomach, led to diagnosis of GS but did not exclude malignancy. After surgical resection of the tumor, the final diagnosis of GS without lymph node metastasis was made. No recurrence has occurred in the 6 years of follow-up. CONCLUSION A clearly defined ultrasonic characteristic profile of GS is important to improve diagnostic accuracy.