Schwannoma of the esophagus: a case exhibiting high<sup>18</sup>F-fluorodeoxyglucose uptake in positron emission tomography imaging

Matsuki, Atsushi; Kosugi, Shin‐ichi; Kanda, Tatsuo; Komukai, Shintaro; Ohashi, Masahiro; Umezu, Hajime; Mashima, Yasuoki; Suzuki, Tomoaki; Hatakeyama, K

doi:10.1111/j.1442-2050.2007.00712.x

Cited by 43 publications

(23 citation statements)

References 15 publications

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“…The head and neck region is the most prevalent location for schwannoma to occur; they are rarely observed in the gastrointestinal tract (1). Conventional schwannoma usually arise from peripheral skin nerves and connective tissue, whereas gastrointestinal schwannoma tumors are derived from Schwann cells of the Auerbach's plexus within the gastrointestinal tract wall (1)(2)(3) and were first reported by Daimaru et al in 1988 (1). As benign mesenchymal tumors, schwannomas only account for 1-2% of alimentary tract mesenchymal tumors (2,3).…”

Section: Introductionmentioning

confidence: 99%

“…Conventional schwannoma usually arise from peripheral skin nerves and connective tissue, whereas gastrointestinal schwannoma tumors are derived from Schwann cells of the Auerbach's plexus within the gastrointestinal tract wall (1)(2)(3) and were first reported by Daimaru et al in 1988 (1). As benign mesenchymal tumors, schwannomas only account for 1-2% of alimentary tract mesenchymal tumors (2,3). By contrast, gastrointestinal stromal tumors (GISTs), another type of mesenchymal tumor, are the most common type of submucosal tumor in the alimentary tract.…”

Section: Introductionmentioning

confidence: 99%

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Differentiation between gastrointestinal schwannomas and gastrointestinal stromal tumors by computed tomography

Zhang²,

Peng

et al. 2017

Oncology Letters

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Abstract. The aim of the present study was to identify computed tomography (CT) features to assist in differentiating gastrointestinal schwannomas from gastrointestinal stromal tumors (GISTs). CT images of gastrointestinal schwannomas (n=15) and GISTs (n=50) were analyzed. The absolute CT values of tumor/aorta during plain scan/arterial phase/venous phase were recorded as tumor plain scan (Tp)/aorta plain scan (Ap), tumor arterial phase (Ta)/aorta arterial phase (Aa) and tumor venous phase (Tv)/aorta venous phase (Av), respectively, and normalized CT values of the three phases were calculated as Sp=Tp/Ap, Sa=Ta/Aa and Sv=Tv/Av, respectively. The difference in tumor CT value between arterial and venous phases was calculated and recorded as Tv-a. CT data including tumor size, contour, margin, growth pattern, presence of calcification, cystic change, hemorrhage, ulceration, perilesional lymph nodes (PLNs), local invasion to surrounding structures, metastasis, ascites, vasculatures, enhancement pattern/degree, Tp/Ta/Tv and Sp/Sa/Sv were evaluated for each patient. Receiver operating characteristic (ROC) curve analysis was used to assess the ability of the CT data to differentiate gastrointestinal schwannomas from GISTs. Compared with GISTs, gastrointestinal schwannomas more frequently demonstrated round contouring, relatively smaller tumor size, a homogeneous enhancement pattern, with the presence of PLNs and a higher level of vasculature (P<0.05), whilst the presence of cystic changes were more common in GISTs compared with gastrointestinal schwannomas (P<0.05). The Sa, Ta and Tv-a of gastrointestinal schwannomas were less compared with those of GISTs (P<0.05). The difference in margin, growth pattern, intra-tumoral calcifications and hemorrhage were insignificant (P>0.05). ROC analysis indicated that tumor size, cystic change, the presence of PLNs, tumor enhancement pattern and Sa demonstrated improved diagnostic potential compared with others [area under the curve (AUC) >0.7], amongst which cystic change demonstrated the best diagnostic ability (AUC=0.82). Size exhibited the highest sensitivity, 90%, and cystic change, Sa exhibited the best specificity, 87%. Quantitative analysis indicated that certain features aided the differentiation between gastrointestinal schwannomas and GISTs using CT imaging. IntroductionSchwannoma are benign tumors arising from Schwann cells in the sheaths of peripheral nerves. Schwannoma are homogeneous tumors and may occur in any tissue of the body. The head and neck region is the most prevalent location for schwannoma to occur; they are rarely observed in the gastrointestinal tract (1). Conventional schwannoma usually arise from peripheral skin nerves and connective tissue, whereas gastrointestinal schwannoma tumors are derived from Schwann cells of the Auerbach's plexus within the gastrointestinal tract wall (1-3) and were first reported by Daimaru et al in 1988 (1)

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differentiation between gastrointestinal schwannomas and gastrointestinal stromal tumors by computed tomography

Zhang²,

Peng

et al. 2017

Oncology Letters

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“…FDG-PET imaging is increasingly being used in the field of clinical oncology because it enables the functional imaging of viable tumor tissue [4]. To date there have been five reported cases of esophageal schwannoma with FDG-PET findings, including the present cases [5][6][7]. All of the presented cases were histologically benign esophageal schwannomas that were FDG-positive (Table 1).…”

Section: Discussionmentioning

confidence: 81%

Two cases of benign esophageal schwannoma with positive FDG-PET findings

et al. 2011

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We report two cases of rare benign esophageal schwannoma showing high uptake of radiotracer on [ 18 F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET). Case 1 was a 78-year-old woman with a tumor (50 9 30 9 30 mm) located on the right side of the upper thoracic esophagus. Case 2 was a 70-year-old woman with a tumor (40 9 35 9 27 mm) located in the left anterior wall of the thoracic-to-cervical esophagus. Both tumors were enucleated and histologically diagnosed as benign esophageal schwannoma with nuclear palisading and lymphoid cuffing (Antoni A type). Immunohistochemical staining showed positivity for S-100 protein.There have been five reported cases of esophageal schwannoma with FDG-PET findings, including the present two cases. All five tumors were FDG-PET positive and presented histologically as benign esophageal schwannoma. There was no association between histological malignancy and FDG uptake. We therefore propose that the malignant potential of esophageal schwannomas cannot be evaluated using FDG-PET.

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“…Esophageal schwannomas are exceedingly rare with only a handful of cases reported in the literature [3]. A literature review performed for the past decade, 2005 -2015, revealed a total of 21 cases of which two cases were of concurrent esophageal schwannomas [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The surgical approaches to these include four thoracoscopic, six thoracotomy, five cervical approaches, and five esophagectomies or partial esophagectomies.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Enucleation of Schwannoma Masquerading as a Leiomyoma

2017

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We present a case, literature review, and video of a transabdominal laparoscopic enucleation of an esophageal schwannoma. A 53-yearold female with dysphagia was found to have a 23 × 27 mm mass in the lower esophagus, which was initially diagnosed as a leiomyoma on endoscopic ultrasound without biopsy. At the time of her laparoscopic enucleation 12 months later, the lesion had grown to 60 × 55 × 30 mm and was excised with a full-thickness segment of the esophageal wall, with closure of the resulting defect over a bougie. Postoperatively, the patient's recovery was complicated by an esophageal leak which was successfully managed with endoscopic drainage. Esophageal schwannomas are rare esophageal lesions that have historically been treated with esophagectomy. Thoracoscopic or laparoscopic enucleations of smaller lesions have been more recently reported but larger lesions have usually required open surgery. Internally placed endoscopic drains have previously been shown to be a valid alternative to external drainage in patients with contained collections after resection surgery. They have the advantage of allowing patients to continue oral fluids during the recovery phase rather than relying on enteral or parenteral feeding. We propose that laparoscopic transabdominal enucleation of esophageal schwannoma with closure of the resulting full-thickness defect be considered as an organ and function sparing alternative for the management of large lower esophageal schwannomas. We further propose that contained leaks resulting from esophageal operations can successfully be managed with internal endoscopic drainage.

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Schwannoma of the esophagus: a case exhibiting high¹⁸F-fluorodeoxyglucose uptake in positron emission tomography imaging

Cited by 43 publications

References 15 publications

Differentiation between gastrointestinal schwannomas and gastrointestinal stromal tumors by computed tomography

Differentiation between gastrointestinal schwannomas and gastrointestinal stromal tumors by computed tomography

Two cases of benign esophageal schwannoma with positive FDG-PET findings

Laparoscopic Enucleation of Schwannoma Masquerading as a Leiomyoma

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Schwannoma of the esophagus: a case exhibiting high18F-fluorodeoxyglucose uptake in positron emission tomography imaging

Cited by 43 publications

References 15 publications

Differentiation between gastrointestinal schwannomas and gastrointestinal stromal tumors by computed tomography

Differentiation between gastrointestinal schwannomas and gastrointestinal stromal tumors by computed tomography

Two cases of benign esophageal schwannoma with positive FDG-PET findings

Laparoscopic Enucleation of Schwannoma Masquerading as a Leiomyoma

Contact Info

Product

Resources

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Schwannoma of the esophagus: a case exhibiting high¹⁸F-fluorodeoxyglucose uptake in positron emission tomography imaging