Schwannomas of the digestive tract. Observations on a case localizing in the ileum

The schwannomas are rare tumors taking origin from Schwann's cells; even rarer is their location at a peripheral level. Even if they show the macroscopic and microscopic characteristics of a benign tumor, it is possible that they engage malignant course, with possibility of recurrency and of distant metastasis. In the alimentary tract the schwannomas reveal with repeated episodes of digestive hemorrhage which could engage, according to the location, the characters of enterorrhagia or melena. Arteriography has the higher diagnostic sensibility, in course of bleeding. The CT could demonstrate a submucosal neoplasia. The diagnosis of schwannomas is based on the immunohistochemical search of the protein S100, that allows to differentiate them from the tumors of muscular origin, having such tumors common histological and cytological aspects. The schwannomas are today set in the widest chapter of the so-called "stromal tumors of the gastrointestinal tract" (GISTs) with an indefinite malignancy which need surgical excision and an attentive follow-up. The authors report a case of schwannoma located at the first jejunal loop, having had repeated episodes of digestive hemorrhage. The diagnosis was based on the selective arteriography of the upper mesenteric artery and the immunohistochemical search of the protein S100. The surgical treatment consisted of the resection of the jejunal loop, after having sought for eventual multiple locations of the neoplasia