BACKGROUND Gastric schwannomas are rare benign tumors originating from the intramuscular plexus of the stomach and account for just 2.6% of gastric mesenchymal tumors. Gastric schwannoma (GS) with a surface ulcer is very rare. Herein, we report a rare case of an ulcer-bearing GS, which in conjunction with multiple enlarged regional lymph nodes, readily mimicked gastric cancer (GC). CASE PRESENTATION A 79-year-old female presented with poor appetite and intermittent vomiting of gastric contents during the past month. Gastroscopy revealed a giant crateriform ulcer within the stomach body (at the angular notch). Its raised and indurated border was fragile and bled easily. GC was thus suspected. Contrast-enhanced computer tomography (CT) revealed a mild enhancement of the corresponding irregularly thickened gastric wall, and an annular zone of mucosal discontinuity. Enlarged regional lymph nodes were also found, making GC with metastases of lymph nodes our primary concern. 18F-fluorodeoxyglueose position emission tomography (18F-FDG PET)/CT was then performed for further staging. Obviously increased FDG uptake was shown in the gastric lesion ((maximum standardized uptake value (SUVmax) 14.6), but no FDG uptake was observed in the enlarged regional lymph nodes. Given the strong suspicion of GC, subtotal gastrectomy was performed. GS was revealed by postoperative pathology, with no evidence of metastasis in the 13 resected lymph nodes. CONCLUSIONS This was a rare case of GS with a giant surface ulcer and multiple enlarged regional lymph nodes. The uptake of 18F-FDG in the tumor was substantially higher than previously published literature reports. Under these circumstances, it is difficult to be differentiated from GC.

中文翻译：

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具有模仿胃癌的巨大溃疡和淋巴结肿大的胃神经鞘瘤：一例报告。

背景技术胃神经鞘瘤是一种罕见的良性肿瘤，起源于胃的肌内神经丛，仅占胃间充质肿瘤的2.6％。具有表面溃疡的胃神经鞘瘤（GS）非常罕见。在此，我们报告了一个罕见的溃疡性GS病例，它与多个扩大的区域淋巴结结合在一起，很容易模仿胃癌（GC）。病例介绍在过去的一个月中，一位79岁的女性食欲不振，胃内容物间歇性呕吐。胃镜检查发现胃体内部（在角状凹口处）有一个巨大的颅状溃疡。其凸起而结实的边界很脆弱，容易流血。因此怀疑是GC。对比增强计算机断层扫描（CT）显示相应的不规则增厚的胃壁轻度增强，以及粘膜不连续的环形区。还发现了局部淋巴结肿大，使得具有淋巴结转移的GC成为我们的主要关注。然后进行18F-氟脱氧葡萄糖位置发射断层扫描（18F-FDG PET）/ CT进行进一步的分期。胃部病变的FDG摄取明显增加（（最大标准化摄取值（SUVmax）为14.6），但在扩大的区域淋巴结中未观察到FDG摄取，由于强烈怀疑GC，因此行了全胃切除术。结论：这是少见的GS伴有巨大的表面溃疡和多个区域性淋巴结肿大的GS病例，其在肿瘤中对18F-FDG的摄取大大高于以前的病例发表文献报告。