Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2023; 11(11): 2510-2520
Published online Apr 16, 2023. doi: 10.12998/wjcc.v11.i11.2510
Total removal of a large esophageal schwannoma by submucosal tunneling endoscopic resection: A case report and review of literature
Yu-Zhu Mu, Qi Zhang, Jing Zhao, Yan Liu, Ling-Wei Kong, Zhong-Xiang Ding
Yu-Zhu Mu, Department of Radiology, The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Yu-Zhu Mu, Ling-Wei Kong, Zhong-Xiang Ding, Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Qi Zhang, Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Jing Zhao, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Yan Liu, Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Author contributions: MU YZ contributed to the data acquisition and analysis, and writing of the manuscript; Zhang Q contributed to the language editing and writing involving the imaging part of the manuscript; Liu Y and Zhao J contributed to the data collection; Ding ZX and Kong LW contributed to the work concept and language editing and important revisions to the manuscript.
Supported by National Natural Science Foundation of China, No. 81871337; and Medical and Health Science and Technology Projects of Zhejiang Province, No. 2019KY117.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Xiang Ding, Doctor, PhD, Professor, Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. hangzhoudzx73@126.com
Received: December 23, 2022
Peer-review started: December 23, 2022
First decision: January 3, 2023
Revised: January 14, 2023
Accepted: March 21, 2023
Article in press: March 21, 2023
Published online: April 16, 2023
Processing time: 104 Days and 9.2 Hours
Abstract
BACKGROUND

Primary schwannoma is a rare submucosal tumor of the esophagus, which is most often benign, and surgery is the only effective treatment. So far, only a few cases have been reported. Herein, we reported a single case diagnosed with primary esophageal schwannoma that was totally removed by submucosal tunneling endoscopic resection (STER).

CASE SUMMARY

A 62-year-old man presented to the hospital with a history of resection of a malignant gastric tumor and mild dysphagia. Endoscopic examination revealed a large submucosal elevated lesion in the esophagus 25-30 cm from the incisors. Endoscopic ultrasonography detected a 45 mm × 35 mm × 31 mm hypoechoic lesion; chest computed tomography showed a mass of approximately 55 mm × 35 mm × 29 mm. A preliminary examination showed features suggestive of a stromal tumor. Pathological findings indicated esophageal schwannoma. Next, STER alone was performed to completely resect the mass, and the patient recovered well post-surgery. Afterward, the patient was discharged and showed no tumor recurrence at 33 mo of follow-up.

CONCLUSION

Endoscopic resection is still an effective treatment for large esophageal schwannomas (> 30 mm) under meticulous morphological evaluation.

Keywords: Esophageal schwannoma; Submucosal tunneling endoscopic resection; S100; Submucosal; Case report

Core Tip: Primary esophageal schwannoma is a rare esophageal submucosal tumor that is usually benign. The final diagnosis requires histopathological and immunohistochemical examinations. The surgical method depends on the morphology and size of the lesion. Submucosal tunneling endoscopic resection appears to be a feasible treatment for a subset of large esophageal schwannomas with large supero-inferior diameter but the smaller antero-posterior diameter and left-right diameters, which may benefit patients intolerant to surgical treatment.