Mavroeidis Vasileios K, Kandilaris Kosmas, Matthioudakis Dimitrios I, Kaza Stavroula N, Lykoudis Panagis M, Saffioti Francesca, Demonakou Maria
Ann Ital Chir. 2017;88:26-38.
Oesophageal sarcomas are very rare while various histological types have occasionally been reported. Malignant Peripheral Nerve Sheath Tumour (MPNST) of the oesophagus is an exceedingly rare type of oesophageal sarcoma with only thirteen cases previously reported in the world literature. However, it should be included in the differential diagnosis of oesophageal neoplasias. Due to the small number of reported cases, the information about the biological behaviour of this entity is still insufficient. While MPNST is generally considered an aggressive type of tumour with high recurrence rates after surgical treatment and poor prognosis, previous reports of cases with oesophageal localization have recorded satisfactory outcomes overall even with less aggressive therapeutic approaches, although a long-term follow-up is lacking. Herein, we present the case of a 76-year-old female patient with oesophageal MPNST who presented with lymph node and distant metastases at the time of diagnosis, accounting for the second time only that this unusual presentation of this extremely uncommon disease has been reported. In our case, the course of disease was extremely aggressive which resulted in the second recorded death from this entity in the literature. The case presentation is followed by an extensive review of the world literature for the so far reported cases, aiming to highlight all relevant aspects such as demographics, clinical features, diagnostic assessment and findings, histological parameters, treatment and prognosis, and extract valuable previously unpublished conclusions for this rare entity.
Lymph node metastasis, Malignant Peripheral Nerve Sheath Tumour, Malignant schwannoma, Neurogenic sarcoma, Oesophagus, S100.
食管肉瘤非常罕见,虽然偶尔有各种组织学类型的报道。食管恶性外周神经鞘瘤(MPNST)是一种极其罕见的食管肉瘤类型,世界文献中此前仅报道过13例。然而,它应被纳入食管肿瘤的鉴别诊断中。由于报道的病例数量较少,关于该实体生物学行为的信息仍然不足。虽然MPNST通常被认为是一种侵袭性肿瘤,手术治疗后复发率高且预后差,但先前关于食管定位病例的报道总体上记录了令人满意的结果,即使采用的治疗方法不太积极,尽管缺乏长期随访。在此,我们报告一例76岁女性食管MPNST患者,诊断时出现淋巴结和远处转移,这是该极其罕见疾病这种不寻常表现的第二次报道。在我们的病例中,疾病进程极具侵袭性,导致文献中该实体的第二例记录死亡。病例报告之后是对世界文献中迄今为止报道病例的广泛回顾,旨在突出所有相关方面,如人口统计学、临床特征、诊断评估和结果、组织学参数、治疗和预后,并为这个罕见实体提取有价值的先前未发表的结论。
淋巴结转移;恶性外周神经鞘瘤;恶性施万细胞瘤;神经源性肉瘤;食管;S100