Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2023; 11(5): 1094-1098
Published online Feb 16, 2023. doi: 10.12998/wjcc.v11.i5.1094
Giant myxofibrosarcoma of the esophagus treated by endoscopic submucosal dissection: A case report
Xiao-Song Wang, Cheng-Guang Zhao, Hui-Ming Wang, Xiao-Yan Wang
Xiao-Song Wang, Department of Digestive Diseases, Suqian First People’s Hospital Affiliated to Nanjing Medical University, Suqian 223800, Jiangsu Province, China
Cheng-Guang Zhao, Hui-Ming Wang, Xiao-Yan Wang, Department of Gastroenterology, Suqian First People’s Hospital Affiliated to Nanjing Medical University, Suqian 223800, Jiangsu Province, China
Author contributions: Wang XS and Wang HM wrote and revised the case report; Zhao CG and Wang XY were responsible for all the clinical aspects of the paper; and all authors issued final approval for the version to be submitted.
Supported by the Key Project of Jiangsu Province, China, No. ZD2022052.
Informed consent statement: Informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Xiao-Yan Wang, MM, Chief Physician, Professor, Department of Gastroenterology, Suqian First People’s Hospital Affiliated to Nanjing Medical University, No. 120 Suzhi Road, Suqian 223800, Jiangsu Province, China. 726343819@qq.com
Received: November 1, 2022
Peer-review started: November 1, 2022
First decision: November 11, 2022
Revised: November 17, 2022
Accepted: January 16, 2023
Article in press: January 16, 2023
Published online: February 16, 2023
Processing time: 105 Days and 2.1 Hours
Abstract
BACKGROUND

Myxofibrosarcoma (MFS) is a fibroblast-derived sarcoma that mainly occurs in subcutaneous tissue. MFS rarely occurs in the gastrointestinal tract, especially in the esophagus.

CASE SUMMARY

A 79-year-old male patient was admitted to our hospital for dysphagia for a week. Computed tomography and electronic gastroscopy showed that a giant mass was located 30 cm from the incisor and extended to the cardia. There was incomplete esophageal stenosis. Endoscopic pathology showed spindle cell lesions, which were considered inflammatory myofibroblast like hyperplasia. Considering the strong demands of the patient and his family, and the fact that most inflammatory myofibroblast tumors are benign, we decided to perform endoscopic submucosal dissection (ESD) even if the tumor size was giant (9.0 cm × 3.0 cm). Postoperative pathological examination resulted in a final diagnosis of MFS. MFS rarely occurs in the gastrointestinal tract, especially in the esophagus. Surgical resection and local adjuvant radiotherapy are the first choices to improve the prognosis. This case report firstly described the ESD for esophageal giant MFS. It suggests that ESD may be an alternative treatment for primary esophageal MFS.

CONCLUSION

This case report for the first time describe the successful treatment of a giant esophageal MFS by ESD, suggesting that ESD may be an alternative treatment for primary esophageal MFS, especially in elderly high-risk patients with obvious dysphagia symptoms.

Keywords: Endoscopic submucosal dissection; Giant myxofibrosarcoma; Esophagus; Case report

Core Tip: For the first time, we report a giant esophageal myxofibrosarcoma (MFS) measuring about 9.0 cm × 3.0 cm. We managed to remove the MFS completely through endoscopic submucosal dissection (ESD) without severe complications. This case suggests that ESD may be an alternative treatment for esophageal MFS, especially in aged high-risk patients with obvious dysphagia symptoms.