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Gastrointestinal Disorders and Treatments / Gastrointestinal Tumor Research and Treatment · Journal article
International Journal of Surgery Case Reports · August 11, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report of a 38-year-old woman with rectal schwannoma initially misdiagnosed as malignant spindle-cell tumor, diagnosed by immunohistochemistry, and treated with laparoscopic total mesorectal excision with clear margins and uneventful recovery. The report illustrates the diagnostic challenge posed by rectal schwannomas mimicking malignancy and documents successful surgical management, but provides no comparative evidence, outcomes data, or follow-up sufficient to establish standard practice.
Case report. 38-year-old woman presenting with abdominal pain, constipation, hematochezia, and weight loss; imaging and colonoscopy revealed rectal mass. Intervention: Laparoscopic total mesorectal excision with clear surgical margins.
Rectal schwannoma presented as a 4 × 5 cm mass located 5 cm above dentate line in a 38-year-old woman Initial pathology suggested malignant spindle cell tumor; immunohistochemistry showed S100 and SOX10 positivity with CD117/DOG1 negativity, confirming schwannoma diagnosis Patient treated with laparoscopic total mesorectal excision with clear surgical margins; postoperative recovery was uneventful with no recurrence observed during follow-up
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Clinicians should maintain awareness that rectal schwannomas may be misdiagnosed preoperatively as malignant spindle-cell tumors; immunohistochemistry with S100, SOX10, CD117, and DOG1 markers is essential for accurate diagnosis. Laparoscopic resection with negative margins appears curative, avoiding unnecessary radical surgery.
Single case report with no comparative data, demonstrating diagnostic challenge and management approach but providing no generalizable evidence on outcomes or optimal treatment protocols.
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Clinicians should maintain awareness that rectal schwannomas may be misdiagnosed preoperatively as malignant spindle-cell tumors; immunohistochemistry with S100, SOX10, CD117, and DOG1 markers is essential for accurate diagnosis. Laparoscopic resection with negative margins appears curative, avoiding unnecessary radical surgery.
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Introduction and importance: Rectal schwannomas are exceptionally rare benign neurogenic tumors arising from Schwann cells of the enteric plexus. They account for a very small proportion of gastrointestinal schwannomas and often mimic malignant spindle-cell tumors such as gastrointestinal stromal tumors or leiomyosarcomas, posing a significant diagnostic challenge. Accurate differentiation is essential to avoid unnecessary radical surgery. Presentation of the case: We report a 38-year-old woman presenting with abdominal pain, constipation, hematochezia, and weight loss. Imaging and colonoscopy revealed a 4 × 5 cm rectal mass located 5 cm above the dentate line. Initial pathology suggested a malignant spindle cell tumor, but immunohistochemistry confirmed S100 and SOX10 positivity and CD117/DOG1 negativity, consistent with a rectal schwannoma. The patient underwent a laparoscopic total mesorectal excision with clear surgical margins. Postoperative recovery was uneventful, and no recurrence has been observed during follow-up. Clinical discussion: Due to their nonspecific presentation and radiologic overlap with other rectal neoplasms, rectal schwannomas are frequently misdiagnosed preoperatively. Histopathologic and immunohistochemical analysis remains the cornerstone of diagnosis. Surgical excision with negative margins is curative, while the role of adjuvant therapy is limited. Long-term follow-up is recommended due to uncertain patterns of recurrence. Conclusion: Rectal schwannomas are rare entities that can simulate malignant tumors both clinically and radiologically. Comprehensive diagnostic work-up and complete surgical resection are crucial for accurate diagnosis and favorable outcomes. Further studies are required to establish standardized management and follow-up protocols.
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