Gastric Schwannoma: A Rare Subepithelial Lesion of the Stomach

Gastric schwannomas (GS) are rare, slow-growing, benign subepithelial (SE) lesions of the stomach. These are difficult to differentiate preoperatively from other types of SE lesions, as the gross appearance and clinical presentation are very similar especially the gastrointestinal stromal tumors (GISTs), which are the most common SE lesions of the stomach. We present the case of a 35-year-old Asian man with a one-month history of intermittent, right, upper quadrant pain and hematemesis. Preoperatively, intravenous contrast-enhanced computer tomography scan (CECT) showed a well-circumscribed lesion in the upper abdomen closer to the stomach’s lesser curvature. Endoscopic ultrasound revealed an ulcerated subepithelial lesion and subsequent biopsy with a 22-gauge fine-needle biopsy (22G FNB) needle confirmed the diagnosis of GS. The patient underwent distal gastrectomy and a Bilroth 1 procedure. The postoperative biopsy was consistent with the initial one, therefore supporting the diagnosis of gastric schwannoma. Postoperatively, the recovery remained uneventful.