Wang TY, Wang BL, Wang FR, Jing MY, Zhang LD, Zhang DK. Thoracoscopic resection of a large lower esophageal schwannoma: A case report and review of the literature. World J Clin Cases 2021; 9(35): 11061-11070 [PMID: 35047619 DOI: 10.12998/wjcc.v9.i35.11061]
Corresponding Author of This Article
De-Kui Zhang, MD, Chief Doctor, Professor, Department of Gastroenterology, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730030, Gansu Province, China. zhangdk8616@126.com
Research Domain of This Article
Medicine, Research & Experimental
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/
Tian-Yi Wang, Bian-Li Wang, Lu-Dan Zhang, De-Kui Zhang, Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Fu-Rong Wang, Department of Pathology, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Meng-Yuan Jing, Department of Radiology, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Author contributions: Wang TY searched literature data and drafted the manuscript; Wang BL designed and organized the manuscript; Wang FR provided and checked histopathological images; Jing MY and Zhang LD collected literature data and processed the images; Zhang DK designed the report and critically revised the manuscript; All authors have approved the final article manuscript as submitted.
Supported bySupported by National Natural Science Foundation of China, No. 81770525.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: De-Kui Zhang, MD, Chief Doctor, Professor, Department of Gastroenterology, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730030, Gansu Province, China. zhangdk8616@126.com
Received: June 19, 2021 Peer-review started: June 19, 2021 First decision: July 16, 2021 Revised: July 28, 2021 Accepted: September 15, 2021 Article in press: September 15, 2021 Published online: December 16, 2021 Processing time: 173 Days and 11.4 Hours
Abstract
BACKGROUND
Esophageal schwannomas originating from Schwann cells are extremely rare esophageal tumors. They commonly occur in the upper and middle esophagus but less frequently in the lower esophagus. Herein, we report a rare case of a large lower esophageal schwannoma misdiagnosed as a leiomyoma. We also present a brief literature review on lower esophageal schwannomas.
CASE SUMMARY
A 62-year-old man presented with severe dysphagia lasting 6 mo. A barium esophagogram showed that the lower esophagus was compressed within approximately 5.5 cm. Endoscopy revealed the presence of a large submucosal protuberant lesion in the esophagus at a distance of 32-38 cm from the incisors. Endoscopic ultrasound findings demonstrated a 4.5 cm × 5.0 cm hypoechoic lesion. Chest computed tomography revealed a mass of size approximately 53 mm × 39 mm × 50 mm. Initial tests revealed features indicative of leiomyoma. After multidisciplinary discussions, the patient underwent a video-assisted thoracoscopic partial esophagectomy. Further investigation involving immunohistochemical examination confirming palisading spindle cells as positive for S100 and Sox10 led to the final diagnosis of a lower esophageal schwannoma. There was no tumor recurrence or metastasis during follow-up.
CONCLUSION
The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination. The early appropriate surgery favors a remarkable prognosis.
Core Tip: Esophageal schwannomas that originate from Schwann cells are extremely rare esophageal tumors. The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination findings. If esophageal schwannoma is suspected, then early surgery is recommended to completely remove the tumor. The case findings revealed that Sox10 may be a potential molecular marker for esophageal schwannoma, which provides new diagnostic insights.
