{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:42:09Z","timestamp":1767192129131,"version":"3.48.0"},"reference-count":15,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Synchronous gastrointestinal tumors are exceptionally rare, particularly when combining histologically distinct benign and malignant components. Schwannomas represent uncommon mesenchymal tumors of the gastrointestinal tract, most frequently arising in the stomach, while rectal localization is exceedingly unusual. Papillary adenocarcinoma of the gallbladder is an aggressive malignant entity derived from intracholecystic papillary\u2013tubular neoplasms (ICPNs). The coexistence of these two unrelated neoplasms has not been previously reported, making this case of dual tumor pathogenesis clinically and academically significant. Case Presentation: A 68-year-old female was admitted for surgical management of grade IV uterovaginal prolapse. Preoperative imaging incidentally revealed a well-circumscribed rectal wall mass and gallstones. A combined abdominopelvic operation was performed, including total hysterectomy with bilateral adnexectomy (Wiart procedure), rectosigmoid resection with colorectal anastomosis, and bipolar cholecystectomy. Intraoperatively, a firm intramural rectal lesion and a friable papillary mass in the gallbladder fundus were identified. Histopathologic examination confirmed a benign rectal schwannoma (S-100 positive, CD117\/DOG-1 negative) and a papillary adenocarcinoma of the gallbladder, pT3N0M0, with clear resection margins and no lymphovascular or perineural invasion. The postoperative course was uneventful, and the patient remained disease-free at six-month follow-up. Conclusions: This case represents an exceedingly rare benign\u2013malignant synchronous tumor association. The simultaneous occurrence of rectal schwannoma and gallbladder papillary adenocarcinoma underscores the importance of thorough intraoperative exploration and histopathologic evaluation. Complete resection with negative margins and multidisciplinary follow-up remains crucial for optimal outcomes and contributes to understanding dual tumor pathogenesis within the gastrointestinal tract.<\/jats:p>","DOI":"10.3390\/reports9010014","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:08:11Z","timestamp":1767190091000},"page":"14","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual Tumor Pathogenesis in the Gastrointestinal Tract: Synchronous Rectal Schwannoma and Gallbladder Papillary Adenocarcinoma\u2014A Case Report"],"prefix":"10.3390","volume":"9","author":[{"given":"Adrian","family":"Cotovanu","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"General Surgery Clinic No. 1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2109-7557","authenticated-orcid":false,"given":"Catalin Dumitru","family":"Cosma","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"General Surgery Clinic No. 1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calin","family":"Molnar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"General Surgery Clinic No. 1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Gurzu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"Department of Pathology, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius-Alexandru","family":"Beleaua","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"Department of Pathology, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9900-5375","authenticated-orcid":false,"given":"Vlad Olimpiu","family":"Butiurca","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"General Surgery Clinic No. 1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7608-4306","authenticated-orcid":false,"given":"Marian","family":"Botoncea","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"General Surgery Clinic No. 1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s12957-018-1427-1","article-title":"Schwannoma of the colon and rectum: A systematic literature review","volume":"16","author":"Bohlok","year":"2018","journal-title":"World J. Surg. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"384","DOI":"10.3892\/ol.2021.12645","article-title":"Current status of the diagnosis and treatment of gastrointestinal schwannoma (Review)","volume":"21","author":"Qi","year":"2021","journal-title":"Oncol. Lett."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"49","DOI":"10.12998\/wjcc.v1.i1.49","article-title":"Schwannoma of the rectum: A case report and literature review","volume":"1","author":"Zippi","year":"2013","journal-title":"World J. Clin. Cases"},{"key":"ref_4","first-page":"102075","article-title":"Endoscopic full-thickness resection of rectal schwannoma: A case report","volume":"17","author":"Zhang","year":"2025","journal-title":"World J. Gastrointest. Endosc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e9866","DOI":"10.1097\/MD.0000000000009866","article-title":"A case report of rectal schwannoma treated with laparoscopic proctectomy","volume":"97","author":"Zhang","year":"2018","journal-title":"Medicine"},{"key":"ref_6","first-page":"e31946","article-title":"Schwannoma of the ascending colon in a 22-year-old male: A case report","volume":"14","author":"Vohra","year":"2022","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"905","DOI":"10.5858\/2005-129-905-PCOTGA","article-title":"Papillary carcinomas of the gallbladder: Analysis of noninvasive and invasive types","volume":"129","author":"Tuck","year":"2005","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.1097\/MD.0000000000000131","article-title":"Clinicopathological features of gallbladder papillary adenocarcinoma","volume":"93","author":"Wan","year":"2014","journal-title":"Medicine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1097\/PAS.0b013e318262787c","article-title":"Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder: Clinicopathologic and immunohistochemical analysis of 123 cases","volume":"36","author":"Adsay","year":"2012","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1002\/1097-0142(19920915)70:6<1493::AID-CNCR2820700608>3.0.CO;2-U","article-title":"Carcinoma of the gallbladder: Histologic types, stage of disease, grade, and survival rates","volume":"70","author":"Henson","year":"1992","journal-title":"Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/BF01889076","article-title":"Intraluminal papillary carcinoma of the gallbladder: Prognostic value of computed tomography and sonography","volume":"13","author":"Araki","year":"1988","journal-title":"Gastrointest. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S958","DOI":"10.4103\/jcrt.jcrt_976_22","article-title":"An unusual case series of synchronous primary malignancies: Carcinoma gallbladder with renal cell carcinoma, carcinoma gallbladder with carcinoma colon, carcinoma gallbladder with carcinoma breast","volume":"19","author":"Dash","year":"2023","journal-title":"J. Cancer Res. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Xu, Y., Chen, Q.-N., Wang, H., Liu, N.-B., and Shi, B.-M. (2020). Synchronous hepatocellular carcinoma and gallbladder adenocarcinoma with neuroendocrine differentiation: A case report and literature review. BMC Surg., 20.","DOI":"10.1186\/s12893-020-00905-6"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"90","DOI":"10.13104\/imri.2020.24.2.90","article-title":"Synchronous cancers of hepatic angiosarcoma and gallbladder adenocarcinoma, mimicking gallbladder cancer with hepatic invasion: A case report","volume":"24","author":"Choi","year":"2020","journal-title":"Investig. Magn. Reson. Imaging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1148\/rg.2021200087","article-title":"Gallbladder carcinoma and its differential diagnosis at MRI: What radiologists should know","volume":"41","author":"Vendrami","year":"2021","journal-title":"RadioGraphics"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/14\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:36:25Z","timestamp":1767191785000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/14"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["reports9010014"],"URL":"https:\/\/doi.org\/10.3390\/reports9010014","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}