Esophageal schwannoma: a case report
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Esophageal schwannoma: a case report Masahiro Kitada1*, Yoshinari Matsuda1, Satoshi Hayashi1, Kei Ishibashi1, Kensuke Oikawa2 and Naoyuki Miyokawa2
Abstract Most tumorous lesions of the esophagus are esophageal cancers. Benign primary tumors of the esophagus are uncommon, and account for approximately 2% of all esophageal tumors. More than 80% of benign esophageal tumors are leiomyomas, with schwannomas being rare. A 55-year-old woman visited our internal medicine department with complaints of palpitations and discomfort during swallowing. A chest computed tomography scan showed a lobulated tumor (75 × 57 × 80 mm) in the upper to middle mediastinum, with homogenous inner opacity, compressing the esophagus. Upper gastrointestinal endoscopy revealed a smooth-surfaced elevated lesion covered with normal mucosa, and a schwannoma was diagnosed based on the biopsy result. The tumor was large. It was thus considered to be difficult to repair the esophagus by direct anastomosis after tumor resection. Therefore, subtotal esophagectomy and esophagogastrostomy in the right thorax were performed. Histopathological examination revealed spindle-shaped cells in a fasciculated and disarrayed architecture and nuclei in a palisading pattern. Immunohistochemical studies revealed S100 protein positivity and the absence of staining for α smooth muscle actin (αSMA), CD34 and CD117, thereby establishing the diagnosis of benign schwannoma. Her postoperative course was uneventful and there has been no evidence of recurrence to date.
Background The incidence of benign primary tumors of the esophagus is low. Most are leiomyomas, and schwannomas are rare. We report a patient with schwannoma who was referred to us for evaluation of a mediastinal tumor. Detailed examination yielded a diagnosis of schwannoma arising from the esophageal submucosa and radical surgery was performed. Case presentation A 55-year-old woman visited our hospital with complaints of palpitations and discomfort during swallowing. Her medical and familial histories were unremarkable. A frontal chest radiograph showed a smooth round mass, and a lateral radiograph showed a smooth mass slightly larger than 7 cm in diameter in the middle mediastinum between the trachea and the vertebral bodies. A chest computed tomography (CT) scan showed a lobulated tumor (75 × 57 × 80 mm) in the upper to middle mediastinum, with a homogenous inner component, compressing the esophagus (Figure 1). Magnetic resonance imaging (MRI) of the chest revealed no invasion of surrounding * Correspondence: [email protected] 1 Department of Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan Full list of author information is available at the end of the article
organs. On imaging studies, a mesenchymal tumor such as gastrointestinal stromal tumor was suspected. Upper gastrointestinal endoscopy showed a smooth elevated lesion, 22 cm from the incisor teeth. A mucous membrane was accomp
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