IMAGE
OF THE
MONTH
A Rare ‘‘Neurological’’ Cause for Childhood Abdominal Pain
FIGURE 1. Laparoscopic photograph of a retroperitoneal schwannoma before dissection, appearing as an oval-shaped mass embedded in the mesentery. GB ¼ gall bladder; SI ¼ small intestine; TC ¼ transverse colon.
FIGURE 3. High-power photomicrograph of pathognomonic Verocay bodies (inside the circles) demonstrating the typical nuclear palisading around cell processes with hematoxylin and eosin stain (400 original magnification).
FIGURE 2. A solid oval schwannoma (5.8 cm diameter) after the surgical removal.
FIGURE 4. Medium-power photomicrograph demonstrating classical immunoreactivity for schwannoma with S100 stain (200 original magnification).
An 8-year-old African American male child presented with episodes of epigastric and retrosternal abdominal pain lasting for several months, almost always occurring after meals. He was treated with proton pump inhibitor omeprazole without any success. An upper endoscopy ruled out mucosal disease, and normal serum amylase and lipase ruled out pancreatitis. An ultrasound of abdomen revealed a large oval retroperitoneal solid mass, 5.8 cm in diameter, located in proximity to the gastroduodenal junction. The mass was removed laparoscopically (Figs. 1 and 2). Histopathology confirmed the mass to be a schwannoma demonstrating pathognomonic Verocay bodies (Fig. 3) and classical positivity for S-100 staining (Fig. 4) (1,2). A schwannoma is a typically benign and nonrecurring tumor (
OF THE
MONTH
A Rare ‘‘Neurological’’ Cause for Childhood Abdominal Pain
FIGURE 1. Laparoscopic photograph of a retroperitoneal schwannoma before dissection, appearing as an oval-shaped mass embedded in the mesentery. GB ¼ gall bladder; SI ¼ small intestine; TC ¼ transverse colon.
FIGURE 3. High-power photomicrograph of pathognomonic Verocay bodies (inside the circles) demonstrating the typical nuclear palisading around cell processes with hematoxylin and eosin stain (400 original magnification).
FIGURE 2. A solid oval schwannoma (5.8 cm diameter) after the surgical removal.
FIGURE 4. Medium-power photomicrograph demonstrating classical immunoreactivity for schwannoma with S100 stain (200 original magnification).
An 8-year-old African American male child presented with episodes of epigastric and retrosternal abdominal pain lasting for several months, almost always occurring after meals. He was treated with proton pump inhibitor omeprazole without any success. An upper endoscopy ruled out mucosal disease, and normal serum amylase and lipase ruled out pancreatitis. An ultrasound of abdomen revealed a large oval retroperitoneal solid mass, 5.8 cm in diameter, located in proximity to the gastroduodenal junction. The mass was removed laparoscopically (Figs. 1 and 2). Histopathology confirmed the mass to be a schwannoma demonstrating pathognomonic Verocay bodies (Fig. 3) and classical positivity for S-100 staining (Fig. 4) (1,2). A schwannoma is a typically benign and nonrecurring tumor (
