Malignant peripheral nerve sheath tumor of the transverse colon with peritoneal metastasis: a case report.

Background: Malignant peripheral nerve sheath tumors are malignant tumors arising from a peripheral nerve or displaying nerve sheath differentiation. Gastrointestinal malignant peripheral nerve sheath tumors are rare and malignant peripheral nerve sheath tumor of the colon is even rarer. To date, only five cases have been reported as malignant peripheral nerve sheath tumor arising in the colon. This is probably the first case report of malignant peripheral nerve sheath tumor of the transverse colon associated with peritoneal metastasis.
Case Presentation: A 25-year-old Indian man presented with a large abdominal mass. A computed tomography scan revealed a large 18 cm-sized mass in his transverse colon, suggestive of gastrointestinal stromal tumor. A wide local excision was performed. Histopathology showed sheets and fascicles of elongated to spindle-shaped tumor cells showing a moderate degree of pleomorphism and atypia. Based on morphology and immunohistochemistry, a final diagnosis of malignant peripheral nerve sheath tumor of the transverse colon was given. A peritoneal metastatic tumor deposit was identified grossly and confirmed on histopathology.
Conclusion: This is a rare case report discussing the detailed diagnostic approach along with an extensive review of the literature for malignant peripheral nerve sheath tumor arising in the colon.