Wang Xiao-Song, Zhao Cheng-Guang, Wang Hui-Ming, Wang Xiao-Yan
Department of Digestive Diseases, Suqian First People's Hospital Affiliated to Nanjing Medical University, Suqian 223800, Jiangsu Province, China.
Department of Gastroenterology, Suqian First People's Hospital Affiliated to Nanjing Medical University, Suqian 223800, Jiangsu Province, China.
World J Clin Cases. 2023 Feb 16;11(5):1094-1098. doi: 10.12998/wjcc.v11.i5.1094.
Myxofibrosarcoma (MFS) is a fibroblast-derived sarcoma that mainly occurs in subcutaneous tissue. MFS rarely occurs in the gastrointestinal tract, especially in the esophagus.
A 79-year-old male patient was admitted to our hospital for dysphagia for a week. Computed tomography and electronic gastroscopy showed that a giant mass was located 30 cm from the incisor and extended to the cardia. There was incomplete esophageal stenosis. Endoscopic pathology showed spindle cell lesions, which were considered inflammatory myofibroblast like hyperplasia. Considering the strong demands of the patient and his family, and the fact that most inflammatory myofibroblast tumors are benign, we decided to perform endoscopic submucosal dissection (ESD) even if the tumor size was giant (9.0 cm × 3.0 cm). Postoperative pathological examination resulted in a final diagnosis of MFS. MFS rarely occurs in the gastrointestinal tract, especially in the esophagus. Surgical resection and local adjuvant radiotherapy are the first choices to improve the prognosis. This case report firstly described the ESD for esophageal giant MFS. It suggests that ESD may be an alternative treatment for primary esophageal MFS.
This case report for the first time describe the successful treatment of a giant esophageal MFS by ESD, suggesting that ESD may be an alternative treatment for primary esophageal MFS, especially in elderly high-risk patients with obvious dysphagia symptoms.
黏液纤维肉瘤(MFS)是一种起源于成纤维细胞的肉瘤,主要发生于皮下组织。MFS很少发生于胃肠道,尤其是食管。
一名79岁男性患者因吞咽困难1周入院。计算机断层扫描和电子胃镜检查显示,距门齿30 cm处有一巨大肿物,并延伸至贲门。存在不完全性食管狭窄。内镜病理显示梭形细胞病变,考虑为炎性肌纤维母细胞样增生。考虑到患者及其家属的强烈要求,以及大多数炎性肌纤维母细胞瘤为良性这一事实,我们决定即使肿瘤巨大(大小为9.0 cm×3.0 cm)仍行内镜黏膜下剥离术(ESD)。术后病理检查最终诊断为MFS。MFS很少发生于胃肠道,尤其是食管。手术切除和局部辅助放疗是改善预后的首选方法。本病例报告首次描述了食管巨大MFS的ESD治疗。提示ESD可能是原发性食管MFS的一种替代治疗方法。
本病例报告首次描述了ESD成功治疗巨大食管MFS,提示ESD可能是原发性食管MFS的一种替代治疗方法,尤其是对于有明显吞咽困难症状的老年高危患者。