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Are biopsies during endoscopic ultrasonography necessary for a suspected esophageal leiomyoma?Is laparoscopy always feasible?

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World Journal of Clinical Cases 2023年第9期11卷 2116-2118页

作者： Hazem Beji Mohamed Fadhel Chtourou Slim Zribi Yassine Kallel Mahdi Bouassida Hassen Touinsi Department of General Surgery Hospital Mohamed Taher Maamouri Nabeul University of Tunis El Manar-Faculty of Medicine of TunisNabeul 8000Tunisia

The present letter to the editor is related to the work entitled“Large leiomyoma of lower esophagus diagnosed by endoscopic ultrasonography-fine needle aspiration:A case report.”Although endoscopic ultrasonography seems necessary in a suspected leiomyoma of the esophagus,the performance of biopsies via fine needle aspiration is controversial as it increases the risk of complications such as bleeding,infection,and intraoperative perforations.Laparoscopy is the best treatment strategy for small tumors.Laparotomy with tumor enucleation or esophageal resection can be considered in large leiomyomas.

关键词： esophageal leiomyoma Endoscopic ultrasonography Biopsy Surgical resection

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Thoracoscopic resection of a large lower esophageal schwannoma:A case report and review of the literature

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World Journal of Clinical Cases 2021年第35期9卷 11061-11070页

作者： Tian-Yi Wang Bian-Li Wang Fu-Rong Wang Meng-Yuan Jing Lu-Dan Zhang De-Kui Zhang Department of Gastroenterology Lanzhou University Second HospitalLanzhou 730030Gansu ProvinceChina Department of Pathology Lanzhou University Second HospitalLanzhou 730030Gansu ProvinceChina Department of Radiology Lanzhou University Second HospitalLanzhou 730030Gansu ProvinceChina

BACKGROUND 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.CASE SUMMARY 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.CONCLUSION The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination.The early appropriate surgery favors a remarkable prognosis.

关键词： Lower esophagus esophageal schwannoma esophageal leiomyoma S100 Sox10 Case report

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