神經鞘瘤(Schwannoma)為源於包覆在神經外許旺氏細胞(Schwann cell)的腫瘤。腸胃道的神經鞘瘤甚為罕見,位於大腸的神經鞘瘤更為罕見。在此我們提出一個位於升結腸的大腸神經鞘瘤病例報告。病人為65歲中年男性,初期臨床表現為慢性腹瀉六個月。大腸鏡檢查發現升結腸處有一黏膜下腫瘤。腫瘤突入升結腸內,表面呈現慢性潰瘍。大腸鏡切片檢查呈現壞死性發炎(necrotizing inflammation)。另行兩次大腸鏡檢查及切片亦無法適切的取得此黏膜下腫瘤的病理切片。最後病人接受右結腸切除術。術後病理切片證實為良性大腸神經鞘瘤。
Schwannoma is a common soft tissue tumor, arises form Schwann cell, which cover the peripheral nerves. Gastrointestinal schwannomas are rare and colon schwannomas are extremely rare. We report a case of ascending colon schwannoma with the initial presentation of chronic diarrhea. This 65 year-old men had chronic water diarrhea for six months. Colonoscopy exam ination showed a submucosal tumor with ulceration and it protruded into ascending colon. The initial biopsy pathology showed necrotizing inflammation. Another two colonoscopic biopsy also failed to prove the nature of the submucosal tumor. Finally, he received right hemicolectomy with the tumor completely resected. The pathological diagnosis of this tumor was benign gastrointestinal schwannoma.
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