Matsuki A, Kosugi S, Kanda T, Komukai S, Ohashi M, Umezu H, Mashima Y, Suzuki T, Hatakeyama K
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Dis Esophagus. 2009;22(4):E6-E10. doi: 10.1111/j.1442-2050.2007.00712.x.
Esophageal schwannoma is rare and it is difficult preoperatively to confirm a definitive diagnosis, even using current imaging techniques. We present a case of a benign esophageal schwannoma that was surgically excised and confirmed by immunohistochemical staining. Conventional radiological studies, including barium meal, computed tomography and endoscopic examination had shown a solid submucosal tumor of the upper thoracic esophagus but had been unable to confirm the diagnosis. Positron emission tomography was carried out to evaluate the malignant potential and showed a high uptake of 18F-fluorodeoxyglucose (FDG) into the tumor in both the early and delayed phase, suggesting that the tumor was a potentially malignant tumor such as a gastrointestinal stromal tumor. This is the first reported case of esophageal schwannoma that indicated a high FDG uptake. Although consensus has not been reached regarding the precise mechanism of FDG accumulation in schwannomas, we discuss our clinicopathological findings and review other studies of the subject.
食管神经鞘瘤较为罕见,即使使用当前的成像技术,术前也难以确诊。我们报告一例经手术切除并经免疫组化染色证实的良性食管神经鞘瘤病例。包括钡餐、计算机断层扫描和内镜检查在内的传统放射学检查显示,胸段上段食管有一个实性黏膜下肿瘤,但无法确诊。进行正电子发射断层扫描以评估恶性潜能,结果显示肿瘤在早期和延迟期均对18F-氟脱氧葡萄糖(FDG)有高摄取,提示该肿瘤可能是潜在恶性肿瘤,如胃肠道间质瘤。这是首例报告的显示FDG高摄取的食管神经鞘瘤病例。尽管关于FDG在神经鞘瘤中蓄积的确切机制尚未达成共识,但我们讨论了我们的临床病理发现并回顾了该主题的其他研究。