Gastric neurofibroma

　　Neurofibroma can occur at any part of the stomach, but it is more common on the distal lesser curvature of the stomach. The tumor is round, elliptical, or nodular, with a pedicle or not, grows slowly. Most are located subserosal and project outward from the stomach, while a few grow submucosally towards the gastric cavity, causing the gastric mucosa to gradually thin out and even ulcerate. Most gastric neurofibromas are solitary, but they may also be part of a systemic multifocal neurofibromatosis. About 10% of gastric neurofibromas can become malignant.

　　With the development of the disease, various symptoms and signs may appear, which can be manifestations of the disease itself or complications:

　　1. When a tumor invades the skeletal system, it can cause fractures, dislocations, spinal deformities, and complications such as scoliosis, congenital tibial pseudoarthrosis, and congenital clavicular pseudoarthrosis. Compression of the common peroneal nerve by the tumor can cause foot drop.

　　2. When a tumor invades the central nervous system, there may be seizures, and attention should be paid to prevent trauma.

　　3. Neurofibroma can sometimes spontaneously break down and bleed, or internal bleeding can occur in the tumor, which can cause shock in severe cases.

　　4. Large tumors on the limbs can often break down, leading to infection, abscess, and even amputation.

　　5. Pulmonary damage: A few patients can develop diffuse interstitial pneumonia.

　　6. Malignant skin neurofibroma can occasionally develop into neurofibrosarcoma and malignant neurilemmoma. There are also reports of associated Wilms tumor, rhabdomyosarcoma, and chronic myeloid leukemia.

　　Gastric neurofibroma is characterized by bleeding, manifested as hematemesis or melena; another symptom is typical periodic pain similar to that of peptic ulcer disease, which can be temporarily relieved by medication. Tumors near the pylorus or pedunculated neurofibromas can cause intermittent pyloric obstruction symptoms. Subserosal giant tumors compressing the gastric cavity can cause dyspepsia and decreased appetite, etc. However, some patients with gastric neurofibroma have no自觉 symptoms at all. Larger gastric neurofibromas may be palpable in the upper abdomen, with moderate hardness.

　　In terms of diet, patients with neurofibroma should pay attention to avoiding spicy and刺激性, disease-causing, acidic, seafood, beef, mutton, chicken, fish meat, greasy foods such as cigarettes and alcohol, and other greasy foods. It is necessary to avoid spicy and刺激性 foods, mutton, dog meat, chili, chicken meat, fatty meat, fish meat, grapes, pumpkin, coffee, coriander, milk, yogurt, amaranth, honey, tea water, scallion, garlic, white radish, cola, seafood, mung bean, soda, ice cream, cigarettes and alcohol, as well as acidic and greasy foods. It is forbidden to eat off-season vegetables.

　　1. Blood routine examination shows that patients with chronic bleeding have reduced red blood cells and hemoglobin, indicating iron deficiency anemia.

　　2. Fecal occult blood test can show positive results.

　　3. Histopathological examination is helpful for diagnosis.

　　4. X-ray examination imaging shows: nodular bulges of the gastric wall or semicircular filling defects, sometimes shadowing can be seen in the area of filling defects.

　　5. Endoscopic examination shows the characteristics of submucosal tumors, some with pedicles or nodular.

　　1. Foods that are good for the body when eating gastric neurofibroma:

　　Lotus root, large green vegetables, cabbage, tomatoes, cucumbers, eggplants, celery, tofu, lean meat, apples, grapes, pears, bananas, oranges, watermelons, muskmelons, persimmons, walnuts, roasted peanuts, and pine nuts.

　　2. Foods that are best not to eat with gastric neurofibroma:

　　Amaranth, honey, milk, coffee, soda, tea, ice cream, beef, mutton, seafood, chili, scallion, garlic, mung bean food, and greasy food.

　　1. Treatment

　　Gastric neurofibroma has a tendency to malignant transformation, can be complicated by massive hemorrhage, so once the diagnosis is confirmed, surgical treatment should be performed. A single pedunculated tumor, with a thin pedicle, can be removed surgically, including a certain range of normal gastric wall around the tumor. For giant gastric neurofibroma or those with malignant transformation, subtotal gastrectomy or total gastrectomy should be performed according to the extent of the lesion. Biopsy should be done during surgery, and the corresponding surgical method should be adopted according to the biopsy results.

　　2. Prognosis

　　Authors reported 2 cases, one was a 34-year-old male with a tumor located near the pyloric sinus on the greater curvature of the stomach, about 6cm in diameter; the other was a 22-year-old male patient with a tumor located at the bottom of the stomach, about 8cm in diameter. They underwent subtotal resection of the distal or proximal part of the stomach, respectively, and recovered well after surgery. There was no recurrence seen in the follow-up for 5 years.