Esophageal Schwannoma: An Important Differential Diagnosis for Esophageal Subepithelial Lesions

Nashed, Bola; Ayas, Mohamad Fekredeen; Gharib, Hussein; Issa, Mohamed; Fatouh, Khairya; Sebastian, Freny; Backer, Zoheb; Mahat, Krishna; Barawi, Mohammed

doi:10.7759/cureus.27168

Cited by 3 publications

(5 citation statements)

References 4 publications

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“…Typically, dyspnea and dysphagia are the most common complaints; other reported signs and symptoms include chest pain, stridor, hematemesis, cough, and palpable neck mass[ 10 ]. A literature search in the PubMed database identified 40 reported cases[ 1 , 2 , 6 - 36 ] published between 2011 and October 2022, which are listed in Table 1 . Statistical analysis of baseline information, clinical symptoms, tumor size, and management methods are shown in Tables 2 - 4 .…”

Section: Discussionmentioning

confidence: 99%

“…However, in all these reports, including cases of esophageal schwannomas treated endoscopically over the past 12 years[ 11 , 12 , 17 , 36 ], the size discussed was the maximum diameter of the tumor, while the supero-inferior diameter, antero-posterior diameter, and left-right diameter of the tumor were not analyzed separately. Due to the narrow structure of the esophagus, many schwannomas are limited by the wall of the esophagus and typically have a narrow shape, which often leads to smaller antero-posterior diameter and left-right diameters of the masses although the long diameter is very large, and gives more operating space for endoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, resection remains the only effective treatment, especially if the tumor is detected in the early stage[ 8 ]. The maximum diameter of most endoscopically resected masses over the past 12 years was less than 30 mm[ 1 , 2 , 6 - 36 ], but these cases only discussed endoscopic resection according to the maximum diameter of the tumor and did not analyze the three diameter lines of the mass. In this paper, we reported single submucosal tunnel endoscopic resection for an esophageal schwannoma with 55 mm in supero-inferior diameter.…”

Section: Introductionmentioning

confidence: 99%

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Total removal of a large esophageal schwannoma by submucosal tunneling endoscopic resection: A case report and review of literature

Mu¹,

Zhang²,

Zhao³

et al. 2023

World J Clin Cases

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Total removal of a large esophageal schwannoma by submucosal tunneling endoscopic resection: A case report and review of literature

Mu¹,

Zhang²,

Zhao³

et al. 2023

World J Clin Cases

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“…The typical EUS feature of ESGDA is a heterogeneous hypoechoic submucosal tumor located in the third sonographic layer, with a few cystic lesions, considered dilated adenomatous gland ducts[ 4 ]. Differentiation through EUS-guided FNA is helpful to judge the origin of pathology and make the decision for conservative management vs endoscopic or thoracoscopic intervention[ 5 ]. In our case, both cytological and histological analyses showed atypical glandular epithelial cells, so modified ESTD was selected for resection.…”

Section: Discussionmentioning

confidence: 99%

Modified endoscopic submucosal tunnel dissection for large esophageal submucosal gland duct adenoma: A case report

Chen¹,

Xie²,

Jiang³

et al. 2023

World J Gastrointest Surg

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BACKGROUND With the recent improvement of endoscopic techniques, endoscopic ultrasound-guided fine needle aspiration and endoscopic submucosal tunnel dissection (ESTD) have been widely used for accurate diagnosis and dissection acceleration of esophageal tumors. CASE SUMMARY We used a modified submucosal tunnel technique during endoscopic en bloc resection in a 58-year-old man with large esophageal submucosal gland duct adenoma (ESGDA). During modified ESTD, the oral end of the involved mucosa was cut transversely, followed by a submucosal tunnel created from the proximal to the distal end, and the anal end of the involved mucosa blocked by the tumor was incised. As a result of retaining submucosal injection solutions using the submucosal tunnel technique, it was possible to reduce the amount of injection required and increase the efficiency and safety of dissection. CONCLUSION Modified ESTD is an effective treatment strategy for large ESGDAs. Single-tunnel ESTD appears to be a time-saving procedure compared with conventional endoscopic submucosal dissection.

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“…Schwannomas account for 2–6% of gastrointestinal mesenchymal tumors and usually originate in the stomach or intestine. Esophageal schwannoma is rare [ 34 ]. Although esophageal schwannoma has both benign and malignant features; “schwannoma” usually refers to benign tumors [ 35 ].…”

Section: Benign Tumor and Tumor-like Lesionmentioning

confidence: 99%

How to update esophageal masses imaging using literature review (MRI and CT features)

Qu,

Wang,

Zhang

et al. 2024

Insights Imaging

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MRI offers new opportunities for detailed visualization of the different layers of the esophageal wall, as well as early detection and accurate characterization of esophageal lesions. Staging of esophageal tumors including extramural extent of disease, and status of the adjacent organ can also be performed by MRI with higher accuracy compared to other imaging modalities including CT and esophageal endoscopy. Although MDCT appears to be the primary imaging modality that is indicated for preoperative staging of esophageal cancer to assess tumor resectability, MDCT is considered less accurate in T staging. This review aims to update radiologists about emerging imaging techniques and the imaging features of various esophageal masses, emphasizing the imaging features that differentiate between esophageal masses, demonstrating the critical role of MRI in esophageal masses. Critical relevance statement MRI features may help differentiate mucosal high-grade neoplasia from early invasive squamous cell cancer of the esophagus, also esophageal GISTs from leiomyomas, and esophageal malignant melanoma has typical MR features. Key Points MRI can accurately visualize different layers of the esophagus potentially has a role in T staging. MR may accurately delineate esophageal fistulae, especially small mediastinal fistulae. MRI features of various esophageal masses are helpful in the differentiation. Graphical Abstract

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Esophageal Schwannoma: An Important Differential Diagnosis for Esophageal Subepithelial Lesions

Cited by 3 publications

References 4 publications

Total removal of a large esophageal schwannoma by submucosal tunneling endoscopic resection: A case report and review of literature

Total removal of a large esophageal schwannoma by submucosal tunneling endoscopic resection: A case report and review of literature

Modified endoscopic submucosal tunnel dissection for large esophageal submucosal gland duct adenoma: A case report

How to update esophageal masses imaging using literature review (MRI and CT features)

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