Department of Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan.
World J Surg Oncol. 2013 Oct 2;11:253. doi: 10.1186/1477-7819-11-253.
Most tumorous lesions of the esophagus are esophageal cancers. Benign primary tumors of the esophagus are uncommon, and account for approximately 2% of all esophageal tumors. More than 80% of benign esophageal tumors are leiomyomas, with schwannomas being rare. A 55-year-old woman visited our internal medicine department with complaints of palpitations and discomfort during swallowing. A chest computed tomography scan showed a lobulated tumor (75 × 57 × 80 mm) in the upper to middle mediastinum, with homogenous inner opacity, compressing the esophagus. Upper gastrointestinal endoscopy revealed a smooth-surfaced elevated lesion covered with normal mucosa, and a schwannoma was diagnosed based on the biopsy result. The tumor was large. It was thus considered to be difficult to repair the esophagus by direct anastomosis after tumor resection. Therefore, subtotal esophagectomy and esophagogastrostomy in the right thorax were performed. Histopathological examination revealed spindle-shaped cells in a fasciculated and disarrayed architecture and nuclei in a palisading pattern. Immunohistochemical studies revealed S100 protein positivity and the absence of staining for α smooth muscle actin (αSMA), CD34 and CD117, thereby establishing the diagnosis of benign schwannoma. Her postoperative course was uneventful and there has been no evidence of recurrence to date.
大多数食管肿瘤为食管癌。食管良性原发性肿瘤少见，占所有食管肿瘤的约 2%。超过 80%的食管良性肿瘤为平滑肌瘤，神经鞘瘤罕见。一名 55 岁女性因心悸和吞咽不适就诊于我院内科。胸部 CT 扫描显示上纵隔至中纵隔有一分叶状肿瘤（75×57×80mm），密度均匀，压迫食管。上消化道内镜检查发现一表面光滑的隆起性病变，被覆正常黏膜，基于活检结果诊断为神经鞘瘤。肿瘤较大，考虑到肿瘤切除后直接吻合修复食管较为困难，遂行右胸次全食管切除术和食管胃吻合术。组织病理学检查显示梭形细胞呈束状和杂乱排列，细胞核栅栏状排列。免疫组织化学研究显示 S100 蛋白阳性，α 平滑肌肌动蛋白（αSMA）、CD34 和 CD117 染色阴性，从而确诊为良性神经鞘瘤。患者术后恢复顺利，迄今无复发证据。
