Benign schwannoma of the esophagus: Report of two cases with immunohistochemical and ultrastructural studies

Abstract

Two cases of benign schwannoma of the esophagus are presented. The tumors were found in the thoracic esophagus of women of 56 and 64 years of age, respectively, who had complained of dysphagia and back pain. Tumorectomies were performed and the tumors were found to be located within the esophageal wall arising from the muscularis propria. The tumors were examined immunohistochemically and ultrastructurally. These tumors were identical in gross, histological and electron microscopic features. Grossly, the tumors showed yellowish-white cut surfaces without hemorrhage or necrosis. Microscopically, they were composed of spindle-shaped cells showing moderate variation in size and shape, and nuclear palisading. Lymphoid aggregates with germinal centers surrounded the tumors. Immunohistochemically, strong reactions for S-100 protein and neuron-specific enolase were observed in the cytoplasm of spindle cells, whereas reactions for muscle actin and desmin were negative. These findings, together with electron microscopic observations, supported the Schwann cell origin of these tumors.

Isolated cervical esophageal reconstruction for rare esophageal tumors

“…Esophageal schwannoma is rare, with only 19 reported cases. [1][2][3][4][5] Schwannomas tend to arise during the fourth to fifth decades of life and are more common in women and in blacks. [1][2][3] These tumors have been classified as a subset of gastrointestinal stromal tumors.…”

“…4 Tumors in the esophagus most often appear in the cervical segment. 5 Management of esophageal schwannomas remains controversial owing to the lack of knowledge of the natural history of the disease and the difficulty in distinguishing these masses from other types of submucosal tumors before surgery. In their review of 19 published cases, Murase et al 2 reported that none had had a preoperative diagnosis of schwannoma.…”

Benign Schwannoma of the Esophagus Removed by Enucleation: Report of a Case

“…Benign schwannoma of the esophagus has been described in five cases in four reports in the English literature. [4][5][6][7] Seven cases were reported in Japanese and three cases were diagnosed by immunohistochemical studies up until 1997. [15][16][17] These lesions all ranged from 0.5 to 14 cm in greatest diameter.…”

“…18 Positive immunoreactivity for S-100 protein, NSE, Lew 7, laminin, and GFAP indicate the Schwann nature of the tumor. 1,2,7,11,12 Benign schwannomas of the digestive tract are thought to have originated from neuronsupporting cells in the myenteric plexus or site-specific modified Schwann cells. 2 On the other hand, no smooth muscle markers, such as actin and desmine, were positive in these tumors.…”

Schwannoma of the colon: A case report and review of the literature

“…Immunohistochemical examination of the tumor cells is considered the optimal diagnostic tool for this type of tumor (14). Schwannomas usually exhibit positive reactivity for S-100, vimentin and glial fibrillary acidic protein, and no reactivity for CD117, CD34, actin or cytokeratins, which appear more typically in GISTs, gastrointestinal autonomic tumors or muscle tumors (15,16).…”