GASTROINTESTINAL AUTONOMIC NERVE TUMOR OF THE JEJUNUM - CASE-REPORT AND REVIEW OF THE LITERATURE

Gastrointestinal autonomic nerve tumor is very rare and it is difficul t to distinguish this tumor from other gastrointestinal tumors due to the absence of clinical, instrumental and macroscopic features which a llow pre- or intraoperative diagnosis. Our aim was to recognize the ch aracteristic features (preoperative, intraoperative, pathological) tha t would allow diagnosis of gastrointestinal autonomic nerve tumor. A c ase of gastrointestinal autonomic nerve tumor of the jejunum is report ed. Surgical specimen was routinely processed. Immunohistochemical sta ining was performed according to modified immunoperoxidase Avidin-Biot in-Peroxidase Complex method. An electron microscopy study was also pe rformed. The tumor mass showed some characteristic pathological findin gs: histologically, it was composed of spindle cells and epithelioid c ells; immunohistochemically, a focal positivity for Neuron Specific En olase was shown, and finally, ultrastructural examination showed neuro n-like cells with long cytoplasmic processes containing microtubules a nd bulbouns synapse-like structures with dense core neurosecretory-typ e granules. Preoperatively gastrointestinal autonomic nerve tumor of t he jejunum must be considered and treated as a malignant tumor. A corr ect diagnosis is possible only with immunohistochemical and ultrastruc tural studies. It is probably that this tumor is more common than prev iously thought.