Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2021; 9(10): 2218-2227
Published online Apr 6, 2021. doi: 10.12998/wjcc.v9.i10.2218
Comprehensive clinicopathologic characteristics of intraabdominal neurogenic tumors: Single institution experience
Cem Simsek, Meral Uner, Feride Ozkara, Orkun Akman, Aytekin Akyol, Taylan Kav, Cenk Sokmensuer, Gokhan Gedikoglu
Cem Simsek, Taylan Kav, Department of Gastroenterology, Hacettepe University, Ankara 06230, Turkey
Meral Uner, Aytekin Akyol, Cenk Sokmensuer, Gokhan Gedikoglu, Department of Pathology, Hacettepe University, Ankara 06230, Turkey
Feride Ozkara, Department of Internal Medicine, Hacettepe University, Ankara 06230, Turkey
Orkun Akman, Department of Pathology, Yozgat City Hospital, Yozgat 66100, Turkey
Author contributions: Simsek C, Ozkara F, Bugdayci Uner M and Gedikoglu G gathered patient information, analyzed histology, collected data, performed analysis, constructed manuscript; Kav T, Akyol A, Akman O and Sokmensuer C contributed to conception of the study and manuscript preparation.
Institutional review board statement: This study was reviewed and approved by the Hacettepe University Institutional Review Board (Approval No. GO 20-1112).
Informed consent statement: Due to the retrospective nature of the study, the need for informed consent was waived by the Hacettepe University Institutional Review Board.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest, either real or perceived, in relation to this study.
Data sharing statement: Anonymized data are available and can be shared upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cem Simsek, MD, Academic Fellow, Department of Gastroenterology, Hacettepe University, Sihhiye, Ankara 06230, Turkey. cemgsimsek@gmail.com
Received: December 21, 2020
Peer-review started: December 21, 2020
First decision: December 31, 2020
Revised: January 12, 2021
Accepted: February 11, 2021
Article in press: February 11, 2021
Published online: April 6, 2021
Abstract
BACKGROUND

Neurogenic tumors are rare but represent an important consideration in the differential diagnosis of abdominal mesenchymal tumors. Reports on their incidence, pathological features and clinical characteristics are scarce.

AIM

To advance the overall knowledge on the histologic, immunohistochemical, clinical and radiologic characteristics of neurogenic tumors through this case series.

METHODS

An established database of a nationwide tertiary referral center, covering a 15-year period (2005 and 2020), was retrospectively re-evaluated. Diagnoses of neurogenic tumor cases were confirmed by two experts following review of the macroscopic, histological and immunohistochemical records along with findings from analysis of archived tissue sections for each included patient. Tissue microarrays were constructed for cases lacking necessary immunohistochemical studies. Clinical data and follow-up information were collected from the hospital records and the patients themselves, when available.

RESULTS

The study included 19 cases of intraabdominal neurogenic tumors, representing 12 women and 7 men, between 18 and 86 years of age (median: 51 years). Final confirmed diagnoses were 12 schwannomas, 2 diffuse submucosal neuro-fibromatoses, 2 ganglioneuromas, 2 malignant peripheral sheath nerve tumors, and 1 mucosal Schwann cell hamartoma. Sizes of the tumors were variable, with a median diameter of 4 cm; the two largest (> 10 cm) were schwannomas. The majority of cases were asymptomatic at presentation, but the most frequent symptom was abdominal pain. Gastrointestinal tract lesions were detected with endoscopy and extra-luminal lesions were detected with cross-sectional imaging. All cases were S100-positive and CD117-negative; most cases were negative for desmin, epithelial membrane antigen, smooth muscle actin and CD34. In all but 5 cases, the Ki67 proliferation index was ≤ 1%.

CONCLUSION

Re-evaluation of 19 cases of abdominal neurogenic tumors demonstrated con-siderable variability in clinicopathologic characteristics depending on location, dimension and histological features.

Keywords: Neurogenic tumors, Mesenchymal tumors, Schwannoma, Neurofibroma, Malignant peripheral sheath tumor, Intraabdominal

Core Tip: This is the largest single institution study to re-assess abdominal neurogenic tumors listed in an established database of a national tertiary referral center to improve the overall knowledge on the histologic, immunohistochemical, clinical and radiologic characteristics of such tumors. In total, 19 cases of intraabdominal neurogenic tumors with complete clinical, pathologic and immunohistochemical data were included in the analysis. We believe the new insights on clinicopathologic characteristics, related to location, dimension and histological features, will provide guidance to pathologists, gastroenterologists, surgeons and oncologists involved in the diagnosis and management of future cases.