Endoscopic resection of benign esophageal schwannoma: Three case reports and review of literature

Li, Bin; Wang, Xue; Zou, Wenlu; Yu, Simon C.H.; Chen, Yong; Xu, Huilin

doi:10.12998/wjcc.v8.i22.5690

Cited by 6 publications

(13 citation statements)

References 33 publications

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“…The most common submucosal tumors of the gastrointestinal tract are myogenic tumors such as leiomyomas and gastrointestinal stromal tumors[ 8 ]. Neurogenic tumors such as esophageal schwannomas are rare[ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…From the statistics (Table 2 ) on lower esophageal schwannoma, we observed that the ages (years) with the highest prevalence were at 50-59 (38.5%)[ 8 , 13 - 16 ], followed by 20-29 (15.4%)[ 17 , 18 ], 40-49 (15.4%)[ 8 , 19 ], 60-69 (15.4%)[ 20 ], 30-39 (7.7%)[ 21 ], and 70-79 (7.7%)[ 22 ]. The mean age was 50.85 years, and the median age was 54 years, with a standard deviation of 14.536 years.…”

Section: Discussionmentioning

confidence: 99%

“…In the published literature on lower esophageal schwannomas, the tumor size in 6 patients was less than 3 cm; of these, 5 patients (83.3%) underwent endoscopic surgery. For larger lesions (≥ 3 cm) with suspicious features, endoscopic treatment may not be suitable[ 8 ], and surgical operation is required. The tumor size in 5 patients was between 3 cm and 7 cm, including 3 cases (60%) of thoracoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

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Thoracoscopic resection of a large lower esophageal schwannoma: A case report and review of the literature

Wang¹,

Wang²,

Wang³

et al. 2021

WJCC

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Thoracoscopic resection of a large lower esophageal schwannoma: A case report and review of the literature

Wang¹,

Wang²,

Wang³

et al. 2021

WJCC

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“…Similarly, endoscopic treatment of diverticulum-associated intestinal tumors is challenging due to the lack of a muscle layer [ 9 ]. However, there are cases of esophageal schwannoma involving the muscle layer without serious complications after ESD treatment [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term endoscopic submucosal dissection with postoperative lung injury: a case report

Zhu

Hong

et al. 2021

BMC Surg

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Background Endoscopic submucosal dissection (ESD) has been recognized as a safe and minimally invasive technique for the removal of early gastric cancer. Here, we describe a case of extended-duration ESD for a gastric tumor associated with intraoperative perforation and bleeding. Unfortunately, the patient developed acute lung injury (ALI) after the operation. Case presentation: A 72-year-old woman received ESD for a gastric tumor under general anesthesia. Preoperatively, endoscopic ultrasonography (EUS) showed a 3.1 × 3.5 cm hypoechoic, well-defined mass at the junction of the antrum and body of the stomach on the greater curvature, originating in the muscularis propria layer. During the ESD procedure, when the submucosal mass was stripped, it was found to be closely adhered to the muscular layer and serosa layer, and a full-thickness incision was performed. The abdominal cavity was gradually filled with carbon dioxide gas, and abdominal puncture was performed to reduce intra-abdominal hypertension (IAH). Because the mass adhered to the greater omentum and there was more bleeding during the operation, a long duration of hemostasis and suturing of the wound was required. The whole operation lasted nearly 9 h, and total blood loss was 800 ml. After surgery, acute lung injury was suspected, and the patient was sent to the intensive care unit (ICU) for further treatment. Conclusions The operation time of ESD and IAH caused by perforation are closely related to a poor prognosis. We should pay attention to the impact of operation time on patients and improve awareness regarding protecting important organ functions.

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“…(32,33). Several studies have demonstrated the feasibility, safety, and efficacy of endoscopic resection of gastric schwannomas (16,17,(34)(35)(36)(37). Zhai et al (38) retrospectively analyzed 46 cases of gastric schwannomas (16 cases received endoscopic resection, and 30 received surgical resection) and found that patients in the endoscopic resection group had a shorter operative time and lower operation cost than those in the surgical resection group, while there was no significant difference in complete resection and adverse event rates and postoperative hospital stay, but the tumor size of endoscopic resection group was significantly lower than that in the surgical resection group (22.9 vs. 41.0 mm).…”

Section: B C D E F Amentioning

confidence: 99%

Clinicopathological characteristics of gastrointestinal schwannomas: A retrospective analysis of 78 cases

et al. 2022

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IntroductionSchwannomas are tumors arising from Schwan cells of the neural sheath, which rarely occur in the gastrointestinal tract. The aim of the present study was to analyze the clinicopathological features and treatment outcomes of gastrointestinal schwannomas (GISs).MethodsPatients who were diagnosed with GISs in our hospital from January 2010 to December 2021 were selected. Data about demographic characteristics, clinical symptoms, treatment methods and outcomes, pathological results, and follow-up results were retrospectively collected and analyzed.ResultsA total of 78 patients with 79 GISs were included, the female-to-male ratio was 55:23, and the average age was 52.12 ± 12.26 years. One-third (26/78) of the patients were asymptomatic. A total of 79 GISs were removed, and the average size was 3.63 ± 2.03 cm (range, 0.3–10 cm). As for tumor location, 54 GISs were located in the stomach, 14 in the esophagus, 2 in the duodenum, 6 in the colorectum (4 in the colon and 2 in the rectum), and the other 3 in the small intestine. A total of 23 and 55 patients underwent endoscopic and surgical resections, respectively. Compared with surgical resection, endoscopic resection is associated with a smaller diameter, lower cost, and shorter hospital stay. Pathological results revealed that S100 was positive in all the GISs. No recurrence was noticed during a median follow-up of 45 months (range, 6–148 months).ConclusionGISs are rare gastrointestinal tumors with favorable prognoses, which are most commonly seen in the stomach and diagnosed by pathological findings with immunohistochemical staining. Surgical resection remains the standard method for removing GISs, while endoscopic resection may serve as an alternative method for selected patients with GISs and may be attempted in GISs with a diameter of <3 cm and no signs of malignancy.

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Endoscopic resection of benign esophageal schwannoma: Three case reports and review of literature

Cited by 6 publications

References 33 publications

Thoracoscopic resection of a large lower esophageal schwannoma: A case report and review of the literature

Thoracoscopic resection of a large lower esophageal schwannoma: A case report and review of the literature

Long-term endoscopic submucosal dissection with postoperative lung injury: a case report

Clinicopathological characteristics of gastrointestinal schwannomas: A retrospective analysis of 78 cases

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