Long-Term Survival in a Rare Case of Malignant Esophageal Schwannoma Cured by Surgical Excision

Department of Thoracic Surgery, First Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
The Annals of thoracic surgery (Impact Factor: 3.85). 07/2011; 92(1):357-8. DOI: 10.1016/j.athoracsur.2011.01.045
Source: PubMed


A full account is presented of a 44-year-old woman with an extremely rare case of a malignant esophageal schwannoma that had been misdiagnosed as a leiomyoma 3 years earlier. After surgical enucleation, the patient has survived for 6 years without any adjunctive treatment.

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    ABSTRACT: Most tumorous lesions of the esophagus are esophageal cancers. Benign primary tumors of the esophagus are uncommon, and account for approximately 2% of all esophageal tumors. More than 80% of benign esophageal tumors are leiomyomas, with schwannomas being rare. A 55-year-old woman visited our internal medicine department with complaints of palpitations and discomfort during swallowing. A chest computed tomography scan showed a lobulated tumor (75 × 57 × 80 mm) in the upper to middle mediastinum, with homogenous inner opacity, compressing the esophagus. Upper gastrointestinal endoscopy revealed a smooth-surfaced elevated lesion covered with normal mucosa, and a schwannoma was diagnosed based on the biopsy result. The tumor was large. It was thus considered to be difficult to repair the esophagus by direct anastomosis after tumor resection. Therefore, subtotal esophagectomy and esophagogastrostomy in the right thorax were performed. Histopathological examination revealed spindle-shaped cells in a fasciculated and disarrayed architecture and nuclei in a palisading pattern. Immunohistochemical studies revealed S100 protein positivity and the absence of staining for α smooth muscle actin (αSMA), CD34 and CD117, thereby establishing the diagnosis of benign schwannoma. Her postoperative course was uneventful and there has been no evidence of recurrence to date.
    World Journal of Surgical Oncology 10/2013; 11(2):253-253. DOI:10.1186/1477-7819-11-253 · 1.41 Impact Factor
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    ABSTRACT: Background Esophageal schwannomas are very rarely seen neurogenic tumors and constitute less than 2 % of all esophageal tumors. The current study reports a case of benign esophageal schwannoma and re-evaluates esophageal schwannomas including our case with the other 42 cases in the literature. Methods A 61-year-old female patient was referred to our clinic with the complaints of dysphagia and a weight loss. In her upper gastrointestinal system endoscopy, a 20–25-cm submucosal lesion was seen, which compressed the esophagus from outside. On computerized tomography and magnetic resonance imaging of the thorax, a mass lesion was detected at the posterior mediastinum. After a preoperative detailed evaluation, a right posterolateral thoracotomy was performed. The mass was excised with the enucleation technique. The diagnosis of benign esophageal schwannoma was made with immunohistochemical examination. Results Postoperative period was uneventful. Conclusions Generally, the prognosis of esophageal schwannomas is excellent. Complete removal of the mass producing a negative surgical margin, and in malignant cases, excision of the regional lymph nodes, should be essential for long-term disease-free survival.
    European Surgery 04/2014; 46(2):90-95. DOI:10.1007/s10353-014-0252-1 · 0.27 Impact Factor
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    ABSTRACT: Esophageal schwannoma is a rare tumor first described in 1967 by Chaterlin and Fissore. These tumors are most commonly found incidentally or from diagnostic work up of dysphagia or dyspnea. This entity cannot be diagnosed on clinical or radiographic basis alone. Histology demonstrates palisading spindle cells, few if any mitotic figures, and a peripheral cuff of lymphoid cells. Immunohistochemically, tumor cells stain positive for S100, a characteristic marker of Schwann cells. Once diagnosed, surgical enucleation is the typical treatment method employed.
    Rare tumors 05/2014; 6(2):5361. DOI:10.4081/rt.2014.5361
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