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      Neurofibroma of the stomach without Recklinghausen's disease: a case report

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          Abstract

          Neurofibromas of the stomach can occur in the course of Recklinghausen's disease. Sporadic gastric neurofibroma appears rarely. This tumour may look like an ulcer and can be a cause of abdominal pain, nausea, and bleeding from the gastrointestinal tract. We reported a 61-year-old women complaining of stomachache for several months. Gastroscopy revealed a tumour with ulceration in the prepyloric part of the stomach. Helicobacter pylori infection was also present. Helicobacter pylori eradication and prolonged treatment of proton pump inhibitors did not decrease the ailments or the size of the tumour. It was not possible to determine the nature and origin of the tumour by carrying out examinations such as endoscopic ultrasound and computed tomography of the abdomen. Only after surgery and histopathological examination with immunohistochemistry was this tumour identified as a neurofibroma. In order to differentiate the tumour the following immunohistochemical examinations were carried out: CD34 (slightly +), CD117 (–), S-100 (+), desmin (–), NSE (+), GFAP (–), SMA (–), bc12 (–), CD99 (–), ALK1 (–), and MiB (1–1.5%). In such cases excision of the tumour is the preferred treatment.

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          Gastrointestinal neurofibromatosis: an unusual cause of gastric outlet obstruction.

          Robert R Bakker, M Haber, U. García-González (2005)
          Neurofibromatosis type-1 (NF-1), also known as von Recklinghausen disease, is a common autosomal dominant condition occurring in approximately 1/3000 births. NF-1 is known to be associated with gastrointestinal neoplasms in 2-25 per cent of patients. We report the first case of gastric outlet obstruction with perforation caused by neurofibroma in a patient with NF-1. The literature is reviewed, examining 61 previously reported cases of noncarcinoid gastrointestinal (GI) neoplasms in patients with NF-1 for symptoms, location, and types of neoplasms. Neoplasms were located most often in the small intestine (72%). Neurofibromas, found in 52 per cent of patients, were the most frequently diagnosed benign neoplasms followed by leiomyomas (13%), ganglioneurofibromas (9.8%), and gastrointestinal stomal tumor (GIST) (6.5%). Adenocarcinoma was present in 23 per cent of patients. Patients with NF-1 and GI symptoms are at risk for gastrointestinal neoplasms from which symptomatic patients are likely to experience significant morbidity.
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            Immunohistochemical staining for calretinin is useful for differentiating schwannomas from neurofibromas.

            Samson Fine, Maomi Li, Steve McClain (2004)
            We studied 25 cases of schwannoma and 42 cases of neurofibroma immunohistochemically with antibodies to calretinin and S-100 protein to explore the potential usefulness of calretinin in differentiating schwannomas from neurofibromas. Of 25 schwannomas, 24 (96%) showed moderate to strong staining for calretinin, with the extent of staining ranging from focal to diffuse. In contrast, only 3 (7%) of 42 neurofibromas displayed focal weak to moderate staining with calretinin. All 42 cases of neurofibromas and all 25 cases of schwannomas showed diffuse moderate to strong staining with S-100 protein. Calretinin also labeled mast cells, whose presence was confirmed further by staining for c-kit, which commonly was present in both tumor types in a scattered individual cell pattern easily differentiated from the clustered pattern of neoplastic spindle cells. Taken together, these results indicate that calretinin is detected in almost all schwannomas and in only a small percentage of neurofibromas, suggesting it is a useful marker for differentiating schwannomas from neurofibromas. Although mast cells present in these 2 neoplasms also react with calretinin, the pattern of staining can be distinguished easily from that of neoplastic cells.
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              Solitary neurofibroma of the mesentery: report of a case and review of the literature.

              Gaetano Magro, Maria Piana, Carmelo Venti … (2000)
              Neurofibromas of the gastrointestinal tract are usually associated with neurofibromatosis type 1 (Nfl), or they are exclusive manifestations of the so-called "familial intestinal neurofibromatosis". Gastrointestinal neurofibromas can rarely occur as sporadic lesions in the jejunum and stomach, and only exceptionally in the mesentery. A critical review of the literature revealed that only seven cases of solitary neurofibromas (SNFs) of the mesentery (six in the ileal mesentery; one in the gastrocolic mesentery) have been reported in patients without stigmata of Nf1. We report the clinicopathologic features of an additional case of SNF of the ileal mesentery, incidentally found in a patient with an advanced gastric carcinoma. Since there is increasing evidence that some patients may have some features of Nf1, including dermal or nodular SNFs alone - limited to one or more body segments - (segmental Nf1), the possibility that SNFs of the mesentery may also represent a segmental manifestation of Nf1 is postulated.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Prz Gastroenterol
                Journal ID (iso-abbrev): Prz Gastroenterol
                Journal ID (publisher-id): PG
                Title: Przegla̜d Gastroenterologiczny
                Publisher: Termedia Publishing House
                ISSN (Print): 1895-5770
                ISSN (Electronic): 1897-4317
                Publication date (Electronic): 19 October 2014
                Publication date (Print): 2014
                Volume: 9
                Issue: 5
                Pages: 310-312
                Affiliations
                [1 ]Department of Gastroenterology with Endoscopic Unit, Medical University of Lublin, Lublin, Poland
                [2 ]Outpatient Clinic of Gastroenterology GASTROMED, Lublin, Poland
                [3 ]First Chair and Department of General and Transplant Surgery and Clinical Nutrition, Medical University of Lublin, Lublin, Poland
                [4 ]Department of Clinical Pathomorphology, Medical University of Lublin, Lublin, Poland
                Author notes
                Address for correspondence: Agnieszka Mądro MD, PhD, Department of Gastroenterology with Endoscopic Unit, Medical University of Lublin, 8 Jaczewski St, 20-950 Lublin, Poland. phone/fax: +48 81 724 45 35. e-mail: agnieszka.madro@ 123456wp.pl
                Article
                Publisher ID: 23749
                DOI: 10.5114/pg.2014.46168
                PMC ID: 4223121
                SO-VID: d75f381b-bf12-41fc-998a-e99f633a6b81
                Copyright © Copyright © 2014 Termedia
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 February 2012
                Date revision received : 23 October 2012
                Date accepted : 08 February 2013
                Categories
                Subject: Case Report

                Keywords: neurofibroma,stomach,ulcer,s-100,recklinghausen's disease
                Data availability:
                Keywords: neurofibroma, stomach, ulcer, s-100, recklinghausen's disease

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