Schultz Luke W, Chen Kevin W, Sullivan Corbin D
Department of Otolaryngology, Head and Neck Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA.
Department of Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA.
Cureus. 2024 Aug 30;16(8):e68211. doi: 10.7759/cureus.68211. eCollection 2024 Aug.
Synovial sarcoma (SS) is an uncommon soft tissue malignancy that typically occurs in surrounding joints. Rarely, this malignancy may occur in the gastrointestinal (GI) tract, including the esophagus. Given the rarity of this malignancy, treatment recommendations are limited. In all reviewed cases, surgical resection was performed via some variation of esophagectomy. Here, we present a novel approach to the treatment of esophageal SS. A 30-year-old patient was found to have a large upper esophageal mass after developing symptoms of dysphagia, cough, and regurgitation. Otolaryngology was consulted for the removal of the mass. A CO laser was used to remove the pedicled mass from the esophageal wall. Given the size of the mass, it could not be removed through the upper esophageal sphincter despite significant effort. The decision was made to allow the mass to pass to the stomach to be digested. The patient had an uncomplicated postoperative course with seemingly complete spontaneous digestion of the tumor and no evidence of residual tumor, metastasis, or recurrence. Frozen section pathology confirmed SS of the esophagus. SS of the esophagus is a rare malignancy that presents unique treatment challenges. This case represents a novel strategy for resecting esophageal SS utilizing transoral esophagoscopy. The preservation of the upper esophageal sphincter may also be accomplished using this approach by allowing for the autodigestion of tumors in some cases. This case also suggests that esophagectomy may not be necessary for all cases of esophageal SS.
滑膜肉瘤（SS）是一种罕见的软组织恶性肿瘤，通常发生在关节周围。极少情况下，这种恶性肿瘤可能发生在胃肠道（GI），包括食管。鉴于这种恶性肿瘤的罕见性，治疗建议有限。在所有回顾的病例中，均通过某种形式的食管切除术进行手术切除。在此，我们介绍一种治疗食管滑膜肉瘤的新方法。一名30岁患者在出现吞咽困难、咳嗽和反流症状后，被发现食管上段有一个大肿块。咨询耳鼻喉科以切除肿块。使用CO激光从食管壁上切除带蒂肿块。鉴于肿块的大小，尽管付出了巨大努力，仍无法通过食管上段括约肌将其切除。决定让肿块进入胃内消化。患者术后过程顺利，肿瘤似乎完全自发消化，且无残留肿瘤、转移或复发的迹象。冰冻切片病理证实为食管滑膜肉瘤。食管滑膜肉瘤是一种罕见的恶性肿瘤，带来独特的治疗挑战。本病例代表了一种利用经口食管镜切除食管滑膜肉瘤的新策略。在某些情况下，通过允许肿瘤自动消化，使用这种方法还可以保留食管上段括约肌。本病例还表明，并非所有食管滑膜肉瘤病例都需要进行食管切除术。
