Author(s): Orla Kneafsey, Alwaleed Abdelgadir, Lisa Comerford and Niamh McCawley

Abstract: Background: Schwannomas are benign, slow-growing tumours that develop from Schwann cells within the neural sheath. While schwannomas classically affect peripheral, motor, sympathetic, or cranial nerves, they are rarely found in the gastrointestinal tract. These tumours are typically asymptomatic and are often discovered incidentally. Definitive diagnosis requires immunohistochemical assessment. Treatment typically involves surgical excision, which is curative in most cases. Malignant transformation is thought to be rare. Case Presentation: We present a rare case of an appendiceal schwannoma in a 58-year-old female who presented with a one-month history of lower back pain, urinary retention, and progressive bilateral lower limb weakness. CT imaging revealed an appendiceal mass. The patient underwent an uncomplicated laparoscopic appendicectomy. Histopathological examination confirmed the diagnosis of an appendiceal schwannoma. Immunohistochemical analysis demonstrated strong positivity for vimentin and S-100 protein, consistent with a Schwann cell origin. Neuroendocrine markers, DOG1, and CD117 were all negative, ruling out other differential diagnoses such as gastrointestinal stromal tumours or neuroendocrine tumours. Postoperative recovery was uneventful, and no additional treatment or follow-up was deemed necessary due to the benign nature of the tumour.Conclusion: This case highlights the uncommon presentation and rarity of appendiceal schwannomas, underscoring the importance of histopathological and immunohistochemical evaluation in achieving a definitive diagnosis. The incidental detection of this tumour during imaging and subsequent laparoscopic appendectomy emphasizes the need to consider such uncommon entities in differential diagnoses, even when presenting symptoms are atypical for gastrointestinal pathology. The patient's atypical symptoms underscore the need for a multidisciplinary approach to diagnosis and management. This case is notable as it contributes to the limited number of reported instances of appendiceal schwannoma.

DOI: 10.22271/27081494.2025.v7.i1b.141

Pages: 77-80 | Views: 116 | Downloads: 50

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