Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.11061
Peer-review started: June 19, 2021
First decision: July 16, 2021
Revised: July 28, 2021
Accepted: September 15, 2021
Article in press: September 15, 2021
Published online: December 16, 2021
Processing time: 173 Days and 11.4 Hours
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.
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.
The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination. The early appropriate surgery favors a remarkable prognosis.
Core Tip: Esophageal schwannomas that originate from Schwann cells are extremely rare esophageal tumors. The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination findings. If esophageal schwannoma is suspected, then early surgery is recommended to completely remove the tumor. The case findings revealed that Sox10 may be a potential molecular marker for esophageal schwannoma, which provides new diagnostic insights.