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Yu JJ, Pei HS, Meng Y. Large isolated fibrous tumors in the upper esophagus: A case report. World J Gastrointest Oncol 2024; 16:543-549. [PMID: 38425389 PMCID: PMC10900160 DOI: 10.4251/wjgo.v16.i2.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/13/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Solitary fibrous tumors (SFT) are rare spindle cell tumors that are usually benign. A total of 10 cases of SFTs in the upper esophagus have ever been reported. Here, we report the anesthetic management of a patient with a large isolated fibrous tumor of the upper esophagus compressing the tracheal membrane. We also provide a literature review of the current research. CASE SUMMARY We report the case of a 49 year old male with "cough aggravation and wheezing after exercise", who underwent esophagectomy for a large isolated fibrous tumor compressing the tracheal membrane in the upper esophagus. We advise the use of a single-lumen tube with a blocker in patients with difficult airways to reduce the incidence of airway injury and fibrinoscopy at all stages of the perioperative period to guide airway management. This case study is the first report of the anesthetic management of a large, isolated fibrous tumor compressing the tracheal membrane in the upper esophagus. CONCLUSION This rare case emphasizes the importance of perioperative management of anesthesia in patients with large isolated fibrous tumors of the upper esophagus that compress the tracheal membrane. The use of blocker reduce the incidence of airway injury and fibrinoscopy at the perioperative period to guide airway management.
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Affiliation(s)
- Jia-Jia Yu
- Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Huan-Shuang Pei
- Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Yu Meng
- Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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2
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Wang XS, Zhao CG, Wang HM, Wang XY. Giant myxofibrosarcoma of the esophagus treated by endoscopic submucosal dissection: A case report. World J Clin Cases 2023; 11:1094-1098. [PMID: 36874423 PMCID: PMC9979301 DOI: 10.12998/wjcc.v11.i5.1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/17/2022] [Accepted: 01/16/2023] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Myxofibrosarcoma (MFS) is a fibroblast-derived sarcoma that mainly occurs in subcutaneous tissue. MFS rarely occurs in the gastrointestinal tract, especially in the esophagus.
CASE SUMMARY A 79-year-old male patient was admitted to our hospital for dysphagia for a week. Computed tomography and electronic gastroscopy showed that a giant mass was located 30 cm from the incisor and extended to the cardia. There was incomplete esophageal stenosis. Endoscopic pathology showed spindle cell lesions, which were considered inflammatory myofibroblast like hyperplasia. Considering the strong demands of the patient and his family, and the fact that most inflammatory myofibroblast tumors are benign, we decided to perform endoscopic submucosal dissection (ESD) even if the tumor size was giant (9.0 cm × 3.0 cm). Postoperative pathological examination resulted in a final diagnosis of MFS. MFS rarely occurs in the gastrointestinal tract, especially in the esophagus. Surgical resection and local adjuvant radiotherapy are the first choices to improve the prognosis. This case report firstly described the ESD for esophageal giant MFS. It suggests that ESD may be an alternative treatment for primary esophageal MFS.
CONCLUSION This case report for the first time describe the successful treatment of a giant esophageal MFS by ESD, suggesting that ESD may be an alternative treatment for primary esophageal MFS, especially in elderly high-risk patients with obvious dysphagia symptoms.
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Affiliation(s)
- Xiao-Song Wang
- Department of Digestive Diseases, Suqian First People’s Hospital Affiliated to Nanjing Medical University, Suqian 223800, Jiangsu Province, China
| | - Cheng-Guang Zhao
- Department of Gastroenterology, Suqian First People’s Hospital Affiliated to Nanjing Medical University, Suqian 223800, Jiangsu Province, China
| | - Hui-Ming Wang
- Department of Gastroenterology, Suqian First People’s Hospital Affiliated to Nanjing Medical University, Suqian 223800, Jiangsu Province, China
| | - Xiao-Yan Wang
- Department of Gastroenterology, Suqian First People’s Hospital Affiliated to Nanjing Medical University, Suqian 223800, Jiangsu Province, China
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Vedula SV, Nickerson TP, Grider DJ. A Novel Cause of Bowel Obstruction in a Patient with Long-Standing Crohn's Disease. Case Rep Pathol 2021; 2021:3278392. [PMID: 34707913 PMCID: PMC8545553 DOI: 10.1155/2021/3278392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/28/2021] [Indexed: 11/18/2022] Open
Abstract
Solitary fibrous tumors are rare tumors of mesenchymal origin. Although most often observed in the lung pleura, they have been reported in varied extrapleural sites. A 70-year-old male with complicated Crohn's disease presented with 3 days of nausea, emesis, constipation, and abdominal pain. Computed Tomography (CT) demonstrated mucosal thickening of the middescending colon, consistent with fibrosing stricture. Surgical excision revealed an unusual, 5 cm mass originating in the subserosa. Histopathology of the lesion was notable for a proliferation of cells with spindle and stellate-shaped nuclei and no appreciable mitotic figures, which extended into the muscularis and submucosa. Immunohistochemistry was STAT6 nuclear positive and cytoplasmic CD34 positive, diagnostic for solitary fibrous tumor (SFT). In this case, the SFT infiltrating into the muscularis propria and subserosa caused the stricture and bowel obstruction. This illustrates that while fibrosing strictures are usually the etiology of bowel obstruction in the setting of Crohn's disease, other rare possible causes should be considered.
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Affiliation(s)
- Satya V. Vedula
- Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA, USA
| | - T. Paul Nickerson
- Department of Surgery, Section of Colorectal Surgery, Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA, USA
| | - Douglas J. Grider
- Department of Basic Science Education, Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA, USA
- Dominion Pathology Associates, 1 Riverside Circle, Roanoke, VA 24016, USA
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Wang W, Bao B, Hu A, Zhu X, Chen Q. Two case reports of rare diseases occurring in rare parts: splenic vein solitary fibrous tumor and liver solitary fibrous tumor. AME Case Rep 2021; 5:17. [PMID: 33912806 DOI: 10.21037/acr-20-142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/06/2021] [Indexed: 11/06/2022]
Abstract
Solitary fibrous tumor (SFT) is a rare soft tissue tumor originating from mesenchymal cells. Here we report two new cases of SFT. One case was a 37-year-old female patient whose primary tumor site was located in the splenic vein and the primary tumor resulted in splenomegaly and hypersplenism; its recurred for many times after surgical resection and eventually transferred to the liver, 4 operations were performed during 10 years of follow-up, and the patient is in a good condition right now. The second case was a 54-year-old male patient whose primary tumor site was located in the liver, spleen and left side of the chest wall. We performed two operations to remove these tumors, totally. Six years later, SFT recurred in the liver, given that the tumor was too large to be surgical resected completely, we chose orthotopic liver transplantation (OLT), and no tumor recurred during 6 years' follow-up, he is also in a good condition right now. The reports of these two cases of SFT are exceedingly rare, especially the splenic vein SFT is the first report case, which helps expand the understanding of SFT. Although the current mainstream treatment of SFT is surgical resection, liver transplantation may be a new option treatment for the huge liver SFT.
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Affiliation(s)
- Wenjing Wang
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Banghe Bao
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anbin Hu
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaofeng Zhu
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qing Chen
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Businello G, Dal Pozzo CA, Sbaraglia M, Mastracci L, Milione M, Saragoni L, Grillo F, Parente P, Remo A, Bellan E, Cappellesso R, Pennelli G, Michelotto M, Fassan M. Histopathological landscape of rare oesophageal neoplasms. World J Gastroenterol 2020; 26:3865-3888. [PMID: 32774063 PMCID: PMC7385561 DOI: 10.3748/wjg.v26.i27.3865] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/19/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023] Open
Abstract
The landscape of neoplastic pathology of the oesophagus is dominated by malignancies of epithelial origin, in particular by oesophageal adenocarcinoma and oesophageal squamous cell carcinoma. However, several other histopathological variants can be distinguished, some associated with peculiar histopathological profiles and prognostic behaviours and frequently underrecognized in clinical practice. The aim of this review is to provide a comprehensive characterization of the main morphological and clinical features of these rare variants of oesophageal neoplastic lesions.
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Affiliation(s)
- Gianluca Businello
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Carlo Alberto Dal Pozzo
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Marta Sbaraglia
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Luca Mastracci
- Department of Surgical and Diagnostic Sciences (DISC), Pathology Unit, University of Genova, Genova 16123, Italy
| | - Massimo Milione
- Department of Pathology and Laboratory Medicine, First Pathology Division, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Luca Saragoni
- Pathology Unit, Morgagni-Pierantoni Hospital, Forlì 47121, Italy
| | - Federica Grillo
- Department of Surgical and Diagnostic Sciences (DISC), Pathology Unit, University of Genova, Genova 16123, Italy
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo 71013, Italy
| | - Andrea Remo
- Department of Pathology, Ospedale Mater Salutis di Legnago, Legnago 37045, Italy
| | - Elena Bellan
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Rocco Cappellesso
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Gianmaria Pennelli
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Mauro Michelotto
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padua, Padua 35121, Italy
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Jacob S, Carroll ND, El-Sayed Ahmed MM, Attia S, Jim Zhai Q, Bower SP, Makey IA. Thoracoabdominal resection of giant malignant esophageal solitary fibrous tumor. J Surg Case Rep 2020; 2020:rjaa152. [PMID: 32699597 PMCID: PMC7365047 DOI: 10.1093/jscr/rjaa152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/27/2020] [Indexed: 11/14/2022] Open
Abstract
Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm. It usually originates from the parietal pleura. SFT originating from the esophagus is exceedingly rare and even more so as a malignancy. We report a 57-year-old patient with a malignant 18 cm SFT of the esophagus that was treated with esophagectomy through a left thoracoabdominal incision. We discuss his surgical and oncologic management.
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Affiliation(s)
- Samuel Jacob
- Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Nels Davis Carroll
- Department of Cardiothoracic Surgery, UT Health San Antonio, San Antonio, TX, USA
| | | | - Steven Attia
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Qihui Jim Zhai
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | - Steven P Bower
- Department of General Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Ian A Makey
- Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA
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Yeung J, de Perrot M. Commentary: Solitary Fibrous Tumor of the Esophagus-Rare but With Typical Characteristics. Semin Thorac Cardiovasc Surg 2019; 32:179-180. [PMID: 31442492 DOI: 10.1053/j.semtcvs.2019.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 08/15/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Jonathan Yeung
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Marc de Perrot
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
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Mubarak MF, Shah JN, Bolton JS, Bansal M, El Chafic AH. Endoscopic resection of a giant solitary fibrous tumor of the esophagus. VideoGIE 2018; 3:343-345. [PMID: 30402579 PMCID: PMC6205867 DOI: 10.1016/j.vgie.2018.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Muhammad F Mubarak
- Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| | - Janak N Shah
- Division of Gastroenterology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| | - John S Bolton
- Department of Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| | - Mona Bansal
- Department of Pathology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| | - Abdul Hamid El Chafic
- Division of Gastroenterology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
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9
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Lin X, Xiang Y, Shi H, Zhang F. Primary intrapulmonary solitary fibrous tumours. Oncol Lett 2018; 15:3653-3661. [PMID: 29467886 PMCID: PMC5796318 DOI: 10.3892/ol.2018.7798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/18/2017] [Indexed: 01/30/2023] Open
Abstract
Due to the extreme rarity of primary intrapulmonary solitary fibrous tumours (SFTs), their clinical course, imaging characteristics, diagnosis, treatment and prognosis are poorly understood. The present study therefore assessed the diagnosis and management of primary intrapulmonary SFTs and systematically reviewed previously reported cases in the literature. A total of 5 patients who underwent resection for primary intrapulmonary SFTs were enrolled in the present study and their clinical course, tumour characteristics, management and survival were assessed in this retrospective study. Relevant studies regarding primary intrapulmonary SFTs were searched using PubMed and tumour characteristics, clinicopathologic features, therapeutic strategy and survival outcomes were reviewed. Of the 5 cases, all were males, with a mean age of 57.6 years (range, 37-68 years). All patients were asymptomatic and were identified incidentally on routine computed tomography examination. A total of 3 patients underwent thoracotomy and 2 patients underwent video-assisted thoracoscopic surgery. All tumours were completely resected. Postoperative haemorrhage occurred in 1 patient and he received surgical intervention for haemostasis. The average hospital stay was 15 (4-22) days, and no mortality occurred. The mean length of the postoperative follow-up was 37.6 (1-67) months. One patient was lost to follow-up, and 4 patients were asymptomatic. A total of 19 studies were identified from database searches. They included a total of 45 patients: Twenty-three males and 22 females (mean age, 59.4 years; range, 7-81 years). A total of 12 patients were asymptomatic, and pain and coughing were the major symptoms. Five, one, two, four, and 17 tumours occurred in the right upper lobe, right middle lobe, right lower lobe, left upper lobe and left lower lobe, respectively. A total of 39 patients underwent surgery, 1 patient underwent radiotherapy, and 1 patient underwent radiofrequency ablation. A total of 22 patients were followed up and the mean length of the postoperative follow-up was 48 (1-168) months. One patient was diagnosed with chest wall metastases, and 5 patients succumbed to mortality. To conclude, primary intrapulmonary SFTs are extremely rare and typically identified incidentally. The present findings indicated that the left lower lobe was the most common site location and complete surgical resection is a safe and effective treatment.
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Affiliation(s)
- Xia Lin
- Department of Cardiothoracic Surgery, Lishui Center Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Yingming Xiang
- Department of Cardiothoracic Surgery, Lishui Center Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Hongcan Shi
- Department of Cardiothoracic Surgery, Clinical College, Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - Fangbiao Zhang
- Department of Cardiothoracic Surgery, Lishui Center Hospital, Lishui, Zhejiang 323000, P.R. China
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Plúa Muñiz KT, Otero Russel R, Velasco López R, Rodríguez López M, García-Abril Alonso JM. Solitary fibrous tumor of the gastroesophageal junction. GASTROENTEROLOGIA Y HEPATOLOGIA 2017; 41:33-35. [PMID: 28089361 DOI: 10.1016/j.gastrohep.2016.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/15/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Katherine T Plúa Muñiz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Río Hortega, Valladolid, España.
| | - Raúl Otero Russel
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Río Hortega, Valladolid, España
| | - Rosalía Velasco López
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Río Hortega, Valladolid, España
| | - Mario Rodríguez López
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Río Hortega, Valladolid, España
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