Mu YZ, Zhang Q, Zhao J, Liu Y, Kong LW, Ding ZX. Total removal of a large esophageal schwannoma by submucosal tunneling endoscopic resection: A case report and review of literature. World J Clin Cases 2023; 11(11): 2510-2520 [PMID: 37123315 DOI: 10.12998/wjcc.v11.i11.2510]
Corresponding Author of This Article
Zhong-Xiang Ding, Doctor, PhD, Professor, Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. hangzhoudzx73@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yu-Zhu Mu, Department of Radiology, The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Yu-Zhu Mu, Ling-Wei Kong, Zhong-Xiang Ding, Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Qi Zhang, Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Jing Zhao, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Yan Liu, Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Author contributions: MU YZ contributed to the data acquisition and analysis, and writing of the manuscript; Zhang Q contributed to the language editing and writing involving the imaging part of the manuscript; Liu Y and Zhao J contributed to the data collection; Ding ZX and Kong LW contributed to the work concept and language editing and important revisions to the manuscript.
Supported byNational Natural Science Foundation of China, No. 81871337; and Medical and Health Science and Technology Projects of Zhejiang Province, No. 2019KY117.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Xiang Ding, Doctor, PhD, Professor, Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. hangzhoudzx73@126.com
Received: December 23, 2022 Peer-review started: December 23, 2022 First decision: January 3, 2023 Revised: January 14, 2023 Accepted: March 21, 2023 Article in press: March 21, 2023 Published online: April 16, 2023 Processing time: 104 Days and 9.2 Hours
Abstract
BACKGROUND
Primary schwannoma is a rare submucosal tumor of the esophagus, which is most often benign, and surgery is the only effective treatment. So far, only a few cases have been reported. Herein, we reported a single case diagnosed with primary esophageal schwannoma that was totally removed by submucosal tunneling endoscopic resection (STER).
CASE SUMMARY
A 62-year-old man presented to the hospital with a history of resection of a malignant gastric tumor and mild dysphagia. Endoscopic examination revealed a large submucosal elevated lesion in the esophagus 25-30 cm from the incisors. Endoscopic ultrasonography detected a 45 mm × 35 mm × 31 mm hypoechoic lesion; chest computed tomography showed a mass of approximately 55 mm × 35 mm × 29 mm. A preliminary examination showed features suggestive of a stromal tumor. Pathological findings indicated esophageal schwannoma. Next, STER alone was performed to completely resect the mass, and the patient recovered well post-surgery. Afterward, the patient was discharged and showed no tumor recurrence at 33 mo of follow-up.
CONCLUSION
Endoscopic resection is still an effective treatment for large esophageal schwannomas (> 30 mm) under meticulous morphological evaluation.
Core Tip: Primary esophageal schwannoma is a rare esophageal submucosal tumor that is usually benign. The final diagnosis requires histopathological and immunohistochemical examinations. The surgical method depends on the morphology and size of the lesion. Submucosal tunneling endoscopic resection appears to be a feasible treatment for a subset of large esophageal schwannomas with large supero-inferior diameter but the smaller antero-posterior diameter and left-right diameters, which may benefit patients intolerant to surgical treatment.
