Gastrointestinal autonomic nerve tumors: a surgical point of view.
OBJECTIVE
Gastrointestinal autonomic nerve tumors are uncommon stromal tumors of the intestinal tract. Their histological appearance is similar to that of other gastrointestinal stromal tumors. We report two cases and performed an analysis of the literature by comparing our findings with the available case reports in the medical literature.


METHODS
Two patients were admitted with abdominal tumor masses. One occurred in the stomach with large multiple liver metastases and the second originated in Meckel's diverticulum. The latter site has never been reported previously. Both patients underwent surgery. In one patient gastrectomy, right liver resection and colon transversum resection were performed to achieve aggressive tumor debulking. In the other patient the tumor bearing diverticulum was removed.


RESULTS
Postoperative recovery of both patients was uneventful. Histological examination, immunohistochemical analysis and electron microscopy revealed the diagnosis of a gastrointestinal autonomic nerve tumor. The patient with the tumor in Meckel's diverticulum died 6 mo after surgery because of pneumonia. The patient with liver metastases have been alive 13 years after initial tumor diagnosis and 7 years after surgery with no evidence of tumor progression. In light of our results, we performed a thorough comparison with available literature reports.


CONCLUSIONS
Radical surgical resection of gastrointestinal autonomic nerve tumors seems to be the only available curative approach to date, and long term survival is possible even in large metastasized tumors.
Department of General Surgery, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria. a.stift@akh-wien.ac.at
Anton
A
Stift
Josef
J
Friedl
Michael
M
Gnant
Friedrich
F
Herbst
Raimund
R
Jakesz
Etienne
E
Wenzl
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D004064:Digestive System / Q000294:innervation; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009362:Neoplasm Metastasis / Q000473:pathology; D009423:Nervous System Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D015415:Biomarkers