Total removal of a large esophageal schwannoma by submucosal tunneling endoscopic resection: A case report and review of literature

Table 1 Esophageal schwannoma case reports in PubMed during the last 12 years

Case	Ref.	Year	Age	Sex	Location	Tumor size (mm)	Symptoms	Management	Malignant findings
1	Choo et al[10]	2011	22	M	Ut	80 × 60 × 30	Cough, dyspnea and dysphagia	Enucleation	Benign
2	Wang et al[2]	2011	44	F	Lt	55 × 44	Progressive dysphagia	Surgical enucleation	Malignant
3	Liu et al[16]	2013	62	F	NA	90 × 40 × 30	Dysphagia and dyspnea	Partial esophagectomy and esophagogastrostomy	Benign
4	Liu et al[17]	2013	NA	NA	NA	< 30	NA	STER	Benign
5	Kitada et al[6]	2013	55	F	UM	75 × 57 × 80	Palpitations and dysphagia	Mini thoracotomy	Benign
6	Gu et al[18]	2014	39	M	UM	35 × 32 × 12	Obstructive sensation	VATS	Benign
7	Jeon et al[19]	2014	63	M	Ut	94 × 89	No symptoms	Thoracotomy	Benign
8	Jeon et al[19]	2014	32	F	Ut	60 × 85 × 40	Intermittent chest pain	VATS	Benign
9	Tomono et al[20]	2015	59	M	Mt	109 × 72 × 71	Dysphagia, dyspnea, disturbed	Subtotal esophagectomy	Benign
10	Wang et al[21]	2015	53	F	NA	NA	NA	Surgical excision	Benign
11	Wang et al[21]	2015	52	F	NA	NA	NA	Surgical excision	Benign
12	Zhang et al[22]	2015	67	F	NA	NA	Dysphagia	Surgical excision	Benign
13	Mishra et al[1]	2016	27	F	Mt	120 × 100 × 101	Dysphagia and palpitations	Surgical enucleation	Malignant
14	Watanabe et al[23]	2016	39	F	Ut	55 × 45 × 24	Epigastric pain, difficulty swallowing	Surgical excision	Benign
15	Chen et al[24]	2016	46	M	Mt	30 × 20 × 17	Discomfort during swallowing	VATS	Benign
16	Chen et al[24]	2016	42	F	Ut	30 × 40 × 40	Dysphagia	Enucleation	Benign
17	Chen et al[24]	2016	58	F	Ut	80 × 60 × 60	Dysphagia	Enucleation	Benign
18	Onodera et al[12]	2017	47	F	Ut	60	Dysphagia	Thoracoscopic + endoscopic excision	Benign
19	Moro et al[25]	2017	66	M	Ut	52 × 40 × 31	Dysphagia	Surgical excision	Benign
20	Zhang et al[13]	2018	48	F	Mt	69 × 36	Dysphagia	Robot-assisted enucleation	Benign
21	Iwata et al[26]	2018	74	F	Ut	80 × 42	Loss of consciousness	Surgical excision	Benign
22	Zhu et al[27]	2019	55	F	Mt	25 × 25 × 20	Dysphagia and chest pain	Left thoracotomy with subtotal esophagectomy	Benign
23	Souza et al[28]	2019	43	M	Ut	70	Pharyngitis, odynophagia, hemoptysis	Surgical excision	Benign
24	Ramos et al[29]	2019	40	F	Ut	80 × 45 × 20	Pharyngitis, odynophagia, dysphagia	Surgical excision	Benign
25	Degheili et al[30]	2019	50	F	Ut	78 × 54 × 105	Dyspnea and dysphagia	Surgical excision	Benign
26	Matteo et al[31]	2020	22	M	Lt	37 × 28 × 70	Dysphagia	Subtotal esophagectomy	Benign
27	Wu et al[7]	2020	67	F	Ut	61 × 46 × 60	Dysphagia and dyspnea	Surgical excision	Benign
28	Li et al[11]	2020	59	M	Lt	14 × 5	Upper abdominal distension	Endoscopic submucosal excision	Benign
29	Li et al[11]	2020	51	F	Mt	18 × 20	Heartburn	STER	Benign
30	Li et al[11]	2020	49	M	Lt	28 × 22	Dysphagia	STER	Benign
31	Wang et al[8]	2021	62	M	Lt	53 × 39 × 50	Severe dysphagia	VATS	Benign
32	Matsui et al[32]	2021	50	M	Lt	20	Asymptomatic	VATS	Benign
33	Khalayleh et al[33]	2021	61	F	Ut	50 × 30	Dysphagia	VATS	Benign
34	Zackria et al[15]	2021	78	F	Ut	30	Dysphagia	FNA	Benign
35	Khan et al[34]	2021	60	F	Lt	76 × 46 × 66	Dysphagia	Right-sided VATS	Benign
36	Wang et al[35]	2022	70	F	Ut	32 × 40 × 54	Dysphagia	VATS	Benign
37	Froiio et al[14]	2022	55	F	Ut	65 × 47	Dysphagia	Robotic enucleation	Benign
38	Gupta et al[9]	2022	62	F	Mt	51 × 31	Dysphagia	FNA	Benign
39	Nashed et al[36]	2022	72	F	Mt	29 × 29 × 21	Dysphagia	STER	Benign
40	Current article	2022	62	M	Mt	55 × 35	Dysphagia	STER	Benign

NA: Not available; F: Female; M: Male; Ut: Upper thoracic esophagus; Mt: Middle thoracic esophagus; Lt: Lower thoracic esophagus; STER: Submucosal tunneling endoscopic resection; FNA: Fine needle aspiration; VATS: Video-assisted thoracoscopic surgery.

Table 2 Clinical characteristics of schwannomas

Characteristics		n (%) s (Total 40)	Characteristics		n (%) s (Total 40)	mean ± SD
Location	Upper/middle	28 (70)	Sex	Male	13 (32.5)
	Lower	7 (17.5)		Female	26 (65.0)
	NA	5 (12.5)		NA	1 (2.5)
Malignant findings	Benign	38 (95)	Age (yr)			55.92 ± 2.17
	Malignant	2 (5)

NA: Not available.

Table 3 Clinical symptoms

Symptoms	n (%) s (Total 40)
Dysphagia/odynophagia	31 (88.57)
Epigastric pain/upper abdominal distension	3 (8.57)
Palpitations/chest pain	4 (11.43)
Dyspnea	5 (14.29)
Cough	1 (2.86)
Hemoptysis	1 (2.86)
Loss of consciousness	1 (2.86)
Pharyngitis/pharyngodynia	2 (5.71)
Asymptomatic	2 (5.71)
NA	5 (14.29)

NA: Not available.

Table 4 Management and tumor size

		n (%) s	Maximum diameter (mm)
Total		40	mean: 67.25 (± 4.72)
			The largest	The smallest	mean ± SD
Management	Surgical excision/VATS	29 (72.5)	120	20	67.25 ± 4.72
	Endoscopic excision/STER	5 (12.5)	29	14	22.75 ± 3.54
	Current article (STER)	1 (2.5)	55
	Robot-assisted excision	2 (5)	69	65
	FNA	2 (5)	51	30
	Thoracoscopic + endoscopic excision	1 (2.5)	60

STER: Submucosal tunneling endoscopic resection; FNA: Fine needle aspiration; VATS: Video-assisted thoracoscopic surgery.