Nishikawa Katsunori, Omura Noburo, Yuda Masami, Tanaka Yujiro, Matsumoto Akira, Tanishima Yuichiro, Ishibashi Yoshiro, Yanaga Katsuhiko, Ikegami Masahiro
1 Department of Surgery, Jikei University, Tokyo, Japan.
Int Surg. 2013 Oct-Dec;98(4):461-5. doi: 10.9738/INTSURG-D-12-00021.1.
Esophageal submucosal tumors are less common than other gastrointestinal tract tumors. Leiomyoma is the most common benign esophageal SMT, accounting for more than 70% of these tumors. We report on a case of a 56-year-old woman with a 3-cm diameter midthoracic esophageal submucosal tumor. Magnetic resonance imaging suggested leiomyoma or neurofibroma. Video-assisted thoracoscopic surgery was performed to enucleate the tumor from the esophageal wall by splitting the muscle layers. The postoperative course was uneventful, and the patient was discharged on postoperative day 8. Immunohistochemical staining confirmed the diagnosis of esophageal neurofibroma. Gastrointestinal tract involvement of neurofibromatous lesions is rare and occurs most frequently as a systemic manifestation of von Recklinghausen disease. Cases of localized esophageal neurofibroma with prior or subsequent evidence of generalized neurofibromatosis have rarely been documented. This is a rare case of isolated esophageal neurofibroma without classic systemic manifestations of generalized neurofibromatosis, and it is the first reported case treated by video-assisted thoracoscopic surgery.
食管黏膜下肿瘤比其他胃肠道肿瘤少见。平滑肌瘤是最常见的食管良性黏膜下肿瘤,占这些肿瘤的70%以上。我们报告一例56岁女性患者,其胸段食管有一个直径3厘米的黏膜下肿瘤。磁共振成像提示为平滑肌瘤或神经纤维瘤。通过电视胸腔镜手术,劈开肌层从食管壁上摘除肿瘤。术后病程顺利,患者于术后第8天出院。免疫组织化学染色确诊为食管神经纤维瘤。神经纤维瘤病性病变累及胃肠道罕见,最常作为冯雷克林霍增氏病的全身表现出现。很少有文献记载局部食管神经纤维瘤伴有既往或后续全身神经纤维瘤病证据的病例。这是一例罕见的孤立性食管神经纤维瘤,无典型的全身神经纤维瘤病表现,也是首例报道经电视胸腔镜手术治疗的病例。