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Benign tumors of the esophagus are uncommon, and primary esophageal schwannoma of the esophagus is even rarer, accounting for 2% of cases. Less than 30 cases have been reported in the literature. Here we report a case of a young man with a symptomatic giant esophageal schwannoma, which was completely removed by laparoscopic three-staged esophagectomy. This is the first case of such a large lesion being removed by a minimally invasive approach. Our patient was a 22-year-old male, presented with dysphagia and dyspnea for five years. An endoscopy and CT scan suggested a giant leiomyoma. Postoperative biopsy revealed a primary esophageal schwannoma. We present our case of benign esophageal tumor measuring about 10.5 cm in greatest dimension. This is the first schwannoma resection performed with the Mckeown technique among the limited case reports in the literature. Esophageal schwannoma must be kept as a possible diagnosis in patients presenting with benign esophageal tumors. Esophagectomy is the mainstay of treatment for giant esophageal schwannomas. Minimally invasive esophagectomy can be safely performed for giant benign esophageal tumors. [ABSTRACT FROM AUTHOR]

Background: Esophageal schwannoma is an extremely rare esophageal submucosal tumor. We report a case of a hybrid surgery for a large esophageal schwannoma that had extended from the cervical to the upper thoracic esophagus by using thoracoscopic and cervical approaches. Case presentation: A 58-year-old male was referred to our hospital for further examination and treatment of dysphagia and weight loss over the past 6 months. Upper gastrointestinal endoscopy revealed a 5.7-cm submucosal tumor from the cervical esophagus to the upper thoracic esophagus. The submucosal tumor was diagnosed as esophageal schwannoma by endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA). Contrast-enhanced CT showed that the tumor had not invaded surrounding organs. Since the tumor extended from the cervical esophagus to the upper thoracic esophagus, we decided that it should be resected by not only the cervical but also the thoracoscopic approach. In operation, the patient was first placed in the prone position, and a thoracoscopic dissection of the upper thoracic esophagus containing the tumor was performed from the surrounding area. After changing the patient's position from prone to supine, a cervical skin incision was performed, and we underwent the tumor enucleation. After enucleation, the esophageal wall was thinned, so the right sternocleidomastoid muscle was used to reinforce the esophageal wall. The tumor size of the specimen was 60 × 52 × 42 mm. The postoperative course was uneventful, and the patient was discharged on the 22nd day after surgery. Conclusions: Enucleation of a large esophageal schwannoma from the cervical to the upper thoracic esophagus could be safely performed using both thoracoscopic and cervical approaches. The sternocleidomastoid muscle flap is useful in the occasion considering stenosis by muscular layer suture. [ABSTRACT FROM AUTHOR]

Esophageal schwannoma (ES) is a rare submucosal tumor, and its complete and safe resection is a topic that deserves special attention. This study aimed to investigate the clinical value of endoscopic ultrasound (EUS) in the diagnosis of ES and the clinical efficacy of endoscopic resection for ES. The clinical data, endoscopic characteristics, endoscopic treatment, postoperative complications, immunohistochemical results, and follow-up records of patients with ES admitted to the Tianjin Medical University General Hospital from January 2012 to January 2022 were retrospectively analyzed. Under white-light endoscopy, 81.8% (9/11) of lesions were submucosal elevations, covering the normal esophageal epithelium. Two of the lesions with redness and erosive surface. Eight lesions (72.7%) appear on EUS originating from the muscularis propria were homogeneous or inhomogeneous hypoechoic signals. Two lesions were inhomogeneous hyperechoic originating from the submucosa or muscularis propria, respectively. One lesion was homogeneous hypoechoic originating from the submucosa. All lesions had no blood flow signals, cystic changes, or calcification, and were completely removed by submucosal tunnel endoscopic resection (STER) or endoscopic submucosal dissection (ESD). All patients did not experience serious adverse events as well as recurrence, metastasis, or cicatricial esophageal stenosis during the follow-up period. ES is a rare submucosal lesion, which endoscopic characteristics are difficult to distinguish from other esophageal submucosal tumors. Endoscopic resection can provide a minimally invasive and alternative treatment for ES. [ABSTRACT FROM AUTHOR]

Esophageal schwannomas are a subset of rare tumors that are difficult to differentiate from other esophageal tumors preoperatively. On endoscopic ultrasound (EUS), esophageal schwannomas generally appear as well-demarcated masses that are heterogeneous, hypoechoic, or mixed-echogenic in nature. We present a case of esophageal schwannoma with atypical EUS findings. EUS revealed two lobulated tumors that originated from the muscularis propria and characterized by heterogeneous hypoechoic features and poor blood flow signals. Right-sided video-assisted thoracoscopic surgery with esophageal tumor enucleation was performed. Immunostaining finally confirmed the diagnosis of an esophageal schwannoma. Esophageal schwannomas tend to show heterogeneous hypoechoic or mixed-echogenic features, but they rarely present with two lobulated masses.

Esophageal schwannomas are a subset of rare tumors that are difficult to differentiate from other esophageal tumors preoperatively. On endoscopic ultrasound (EUS), esophageal schwannomas generally appear as well-demarcated masses that are heterogeneous, hypoechoic, or mixed-echogenic in nature. We present a case of esophageal schwannoma with atypical EUS findings. EUS revealed two lobulated tumors that originated from the muscularis propria and characterized by heterogeneous hypoechoic features and poor blood flow signals. Right-sided video-assisted thoracoscopic surgery with esophageal tumor enucleation was performed. Immunostaining finally confirmed the diagnosis of an esophageal schwannoma. Esophageal schwannomas tend to show heterogeneous hypoechoic or mixed-echogenic features, but they rarely present with two lobulated masses. [ABSTRACT FROM AUTHOR]

Abstract Background Esophageal schwannomas are extremely rare, with few cases reported in the literature. Traditionally, resection of esophageal schwannoma is typically performed using thoracotomy or video-assisted thoracic surgery. However, large, irregular tumors may increase the surgical difficulties of complete enucleation and lead to potential mucosal damage. Moreover, a subtotal esophagectomy cannot be avoided in some conditions. Here, we report the first case of robot-assisted enucleation of a large dumbbell-shaped esophageal schwannoma. Case presentation A 48-year-old woman presenting with a 1-year history of dysphagia was noted to have a homogeneous irregular mass measuring 70 mm in diameter and arising from the submucosal layer of the distal esophagus. A diagnosis of an esophageal submucosal tumor (SMT) was made, most likely leiomyoma. Robot-assisted thoracoscopic excision of the tumor was performed. The da Vinci Surgical System provided delicate dissection in the confined posterior mediastinal space, and the large dumbbell-shaped tumor was completely removed without damage to the mucosal integrity. The operative time was 108 min, and the blood loss was less than 20 ml. The pathology of the tumor was esophageal schwannoma. The patient experienced an unremarkable recovery and was discharged on the fifth day after operation. No symptoms or recurrence were present at the 50-month follow-up postoperatively. Conclusion We present a rare case of large irregular esophageal schwannoma that was excised by robot-assisted surgery. A clear operative field and delicate dissections are critical points for the complete removal of this large esophageal SMT. We demonstrate that robotic treatment of large esophageal schwannoma is minimally invasive and can be successfully applied in such cases.

Objective: Esophageal schwannoma (ES) are rare and mostly benign neurogenic tumors. The clinical misdiagnosis rate of it is high. In this study, the clinicopathologic features of ES in mainland China were studied to better understand the disease and improve the diagnosis and treatment rate. Methods: A systematic review was conducted in accordance with PRISMA guidelines. The keywords "esophageal schwannoma", "esophageal neurinoma" and "esophageal neurilemoma" were searched for databases such as Pubmed, EMbase, Wanfang Database and Chinese National Knowledge Infrastructure. The search time frame for database was until July 2019. Combined with our patient, the clinicopathological data and the diagnosis and treatment of ES were summarized. Results: ES occurs in the upper part of the mediastinum and in the thoracic esophagus in most patients in the neck, upper and middle segments. CT and PET/CT examinations can be used for diagnosis, but the differentiation value of both benign and malignant ES is similar. The histopathological findings of forceps biopsy specimens are often difficult to diagnose, and deep tissue biopsies may increase pathological accuracy. EUS-FNA is also recommended for ES diagnosis, but it may also be misdiagnosed. Pathological features include a fusiform arrangement in a palisade-like structure or a tumor cell arranged in a network to form a loose structure. ES characteristic immunohistochemistry results showed that S-100 protein has strong immunological activity. Conclusion: The definitive diagnosis requires immunohistochemistry, especially immunological reaction with S-100 protein. The appropriate treatment plan should be selected according to the diameter of the lesion. The overall prognosis of ES is good, but attention should be paid to follow-up. [ABSTRACT FROM AUTHOR]

Abstract Background Esophageal schwannomas are rare esophageal submucosal tumors. We herein report a case of a lobulated esophageal schwannoma resected with concurrent approach from the thorax and cervix. Case presentation A 74-year-old woman visited our hospital with complaint of loss of consciousness, and a lobulated mediastinal tumor was discovered by chance in computed tomography. Upper gastrointestinal endoscopy showed a smooth elevated lesion at a position of 23–28 cm from the incisor teeth. A hypermetabolic appearance was noted on positron emission tomography. Based on these data, a gastrointestinal stromal tumor was suspected. The tumor was enucleated at the thoracic cavity while being pushed from the cervical incision. Pathological examination showed an esophageal schwannoma. Conclusions We experienced a case of lobulated esophageal schwannoma with fluorodeoxyglucose accumulation. We resected the tumor with concurrent approach from the thorax and cervix.

Malignant tumors are predominant in the esophagus, in which benign tumors are rare, and esophageal schwannoma is extremely rare. Here, we present a case of a 68-year-old woman with an unexpected chest computed tomography of inhomogeneous, well-defined, progressive delayed enhancement mass, and a paraesophageal lymph node. Mediastinal magnetic resonance imaging revealed an external growth mass in the lower esophagus, with an inhomogeneous signal, multiple internal cysts, and limited diffusion on diffuse-weighted imaging. Upper gastrointestinal radiography revealed a filling defect in the lower segment of the esophagus with no damage to the mucosal surface. Surgical resection and further pathological histology and immunohistochemical examination confirmed the diagnosis of esophageal schwannoma., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Wang et al.)

Esophageal schwannomas are extremely rare esophageal submucosal tumors. Herein, we report a case of simultaneous resection of left lung cancer and an esophageal schwannoma with video‐assisted thoracoscopic surgery. An asymptomatic 74‐year‐old woman received a diagnosis of an esophageal submucosal tumor during the preoperative assessment of a left lung cancer. The esophageal submucosal tumor arose in the left wall of the lower esophagus, and the patient was diagnosed as having a schwannoma by endoscopic ultrasound‐guided fine needle aspiration. She underwent video‐assisted thoracoscopic surgery for the simultaneous removal of both tumors. Her postoperative course was uneventful. Thoracoscopic surgery is less invasive than thoracotomy, and this allowed the patient to undergo simultaneous operations for two tumors. [ABSTRACT FROM AUTHOR]

Highlights • The schwannoma of the esophagus is a rare case report. • We present a review of the main characteristics of this disease. • Aspects covered epidemiological, clinical, surgical, histopathological and immunohistochemical. Abstract Introduction Schwannoma is a tumor of the peripheral nervous system originated in the Schwann cells of the neural sheath. Presentation of case A 43-years-old male complained of odynophagia, dysphagia and hemoptysis. The upper gastrointestinal endoscopy showed a smooth elevated lesion, 20 cm from the incisor teeth, occupying the entire lumen of the esophagus. The chest computed tomography (CT) scan showed a lesion of 7 cm and superior mediastinal, lower paraesophageal and cardiac enlarged lymph nodes. A posterolateral thoracotomy was performed with total esophagectomy without intraoperative complications. The anatomopathological analysis revealed fusocellular mesenchymal neoplasia of low malignancy potential. The immunohistochemical study showed positivity for S-100 protein and KI67 antibodies and absence of staining for CD117, CD34, ALK protein, SMA and Desmin. Thus, the morphological and immunohistochemical findings pointed to the diagnosis of esophageal Schwannoma. Discussion Although rare and indolent, Schwannoma occurs in the peripheral nervous system, being uncommon in the esophagus. Conclusion The immunohistochemical study is essential for the diagnosis, which is based on the positivity for S-100 protein and absence of staining for CD34 and CD117. [ABSTRACT FROM AUTHOR]

Background: Esophageal schwannomas are rare primary submucosal esophageal tumors. We herein report a case of an esophageal schwannoma that was difficult to diagnose. Case presentation: A 39-year-old woman presented with chief complaints of difficulty swallowing and epigastric pain. Enhanced computed tomography of her chest revealed a tumor mass at the upper thoracic esophagus with internal heterogeneity. 18-Fluorodeoxyglucose positron emission tomography/computed tomography showed a hypermetabolic appearance matching the tumor mass; the accumulation had a maximum standardized uptake value of 5.5. We performed endoscopic ultrasound-guided fine-needle aspiration biopsy under general anesthesia, but the small specimens obtained prevented a definitive diagnosis. Thoracoscopic esophagectomy was performed due to the large size of the tumor, suspicion of its malignant potential, and the patient's symptoms. Histopathological examination revealed spindle-shaped cells in a fasciculated and disarrayed architecture in the proper muscle layer. Immunohistochemical studies showed S100 protein positivity and the absence of CD34 and c-kit. We diagnosed the tumor as a benign schwannoma. Conclusions: We herein report a relatively rare case of schwannoma of the esophagus that was diagnosed with difficulty. [ABSTRACT FROM AUTHOR]

Background: Primary schwannoma is a rare submucosal tumor of the esophagus, which is most often benign, and surgery is the only effective treatment. So far, only a few cases have been reported. Herein, we reported a single case diagnosed with primary esophageal schwannoma that was totally removed by submucosal tunneling endoscopic resection (STER)., Case Summary: A 62-year-old man presented to the hospital with a history of resection of a malignant gastric tumor and mild dysphagia. Endoscopic examination revealed a large submucosal elevated lesion in the esophagus 25-30 cm from the incisors. Endoscopic ultrasonography detected a 45 mm × 35 mm × 31 mm hypoechoic lesion; chest computed tomography showed a mass of approximately 55 mm × 35 mm × 29 mm. A preliminary examination showed features suggestive of a stromal tumor. Pathological findings indicated esophageal schwannoma. Next, STER alone was performed to completely resect the mass, and the patient recovered well post-surgery. Afterward, the patient was discharged and showed no tumor recurrence at 33 mo of follow-up., Conclusion: Endoscopic resection is still an effective treatment for large esophageal schwannomas (> 30 mm) under meticulous morphological evaluation., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Peripheral nerve sheath tumors of the esophagus originate from the peripheral nerves in the esophageal plexus. They are extremely rare, slow growing, and cause progressive symptoms; schwannomas are the most common form. Histological studies and immunohistochemistry are required to diagnose and differentiate them from other tumors, including gastrointestinal stromal tumors, and as they are resistant to chemotherapy and radiotherapy, surgical resection is the treatment of choice. We present a case of a man presenting with asymptomatic tumor in the posterior mediastinum that was discovered incidentally on a chest X-ray. The tumor was resected en bloc (esophagectomy), and as malignancy was not confirmed, reconstruction was deferred to a later date (gastric pull-up). The pathology analysis eventually confirmed it was a benign schwannoma that was immunohistochemically positive for S-100 and Ki-67. [ABSTRACT FROM AUTHOR]

We report a rare case of benign esophageal schwannoma showing [F]-fluorodeoxyglucose (FDG) uptake on positron emission tomography computed tomography (PET-CT). A 43-year-old woman diagnosed with left breast cancer was referred to our hospital for further treatment. Preoperative PET-CT showed a significant accumulation [maximum standardized uptake value (SUV) 2.5] in the upper thoracic esophagus. Endoscopy revealed a submucosal tumor about 40 mm in size in the upper thoracic esophagus. Endoscopic ultrasonography-guided fine-needle aspiration biopsy did not reveal the histological diagnosis. The patient underwent thoracoscopic enucleation of the tumor. The resected tumor measured 40 × 20 mm. Microscopically, the tumor consisted of spindle cells. Immunohistochemistry was positive for S-100 and vimentin and was negative for KIT (CD117) and CD34. The final diagnosis was benign esophageal schwannoma. [ABSTRACT FROM AUTHOR]

We report a rare case of esophageal schwannoma with high uptake of radiotracer on [18F]fluoro-2-deoxy- d-glucose positron emission tomography (FDG-PET). A 37-year-old woman underwent surgery for sarcoma of the uterus and received general PET examination for postoperative follow-up, which revealed high uptake at the thoracic esophagus. Esophagography, esophageal endoscopy, endoscopic ultrasonography, and computed tomography (CT) scan confirmed a submucosal tumor, about 20 mm in diameter, in the right wall of the upper thoracic esophagus. We performed thoracoscopic enucleation with the preoperative diagnosis of esophageal leiomyoma or gastrointestinal stromal tumor (GIST). Histopathological examination showed a trabecular arrangement of spindle cells and no evidence of mitosis. Immunohistochemical studies were positive for S-100 protein and negative for c-kit, whereby we diagnosed a benign esophageal schwannoma. Even if benign, schwannomas often show high uptake of FDG, so that the evaluation of whether the tumor is malignant should be made by histological diagnosis. Thoracoscopic resection is less invasive and a clinically useful approach to treat such submucosal tumors of the esophagus. [ABSTRACT FROM AUTHOR]

Background: Esophageal schwannomas originating from Schwann cells are extremely rare esophageal tumors. They commonly occur in the upper and middle esophagus but less frequently in the lower esophagus. Herein, we report a rare case of a large lower esophageal schwannoma misdiagnosed as a leiomyoma. We also present a brief literature review on lower esophageal schwannomas., Case Summary: A 62-year-old man presented with severe dysphagia lasting 6 mo. A barium esophagogram showed that the lower esophagus was compressed within approximately 5.5 cm. Endoscopy revealed the presence of a large submucosal protuberant lesion in the esophagus at a distance of 32-38 cm from the incisors. Endoscopic ultrasound findings demonstrated a 4.5 cm × 5.0 cm hypoechoic lesion. Chest computed tomography revealed a mass of size approximately 53 mm × 39 mm × 50 mm. Initial tests revealed features indicative of leiomyoma. After multidisciplinary discussions, the patient underwent a video-assisted thoracoscopic partial esophagectomy. Further investigation involving immunohistochemical examination confirming palisading spindle cells as positive for S100 and Sox10 led to the final diagnosis of a lower esophageal schwannoma. There was no tumor recurrence or metastasis during follow-up., Conclusion: The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination. The early appropriate surgery favors a remarkable prognosis., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Esophageal schwannomas are uncommon esophageal submucosal benign tumors and are usually treated with surgery., Case Summary: Here, we report three cases of middle/lower thoracic esophageal schwannoma treated successfully with endoscopic resection. These lesions were misdiagnosed as leiomyoma on preoperative imaging. During the endoscopic resection of such tumors, there is a risk of esophageal perforation due to their deep location. If possible, submucosal tunneling endoscopic resection should be used., Conclusion: For larger schwannomas, endoscopy combined with thoracoscopy can be considered for en bloc resection. We performed a mini literature review in order to present the current status of diagnosis and treatment for esophageal schwannoma., Competing Interests: Conflict-of-interest statement: All other authors have nothing to disclose., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Esophageal schwannoma was extremely rare and difficult to differentiate from other submucosal tumors. We present a case of a 55-year-old woman who suffered from dysphagia and retrosternal pain for a month. Endoscopic ultrasonography revealed a submucosal tumor, located 23-25cm from the incisors arising from the esophagus. The patient underwent subtotal esophagectomy. The histopathological finding confirmed the diagnosis of esophageal schwannoma. Her postoperative course was uneventful and free of recurrence 2 years after the operation., Competing Interests: None

Background: Esophageal schwannomas are extremely rare, with few cases reported in the literature. Traditionally, resection of esophageal schwannoma is typically performed using thoracotomy or video-assisted thoracic surgery. However, large, irregular tumors may increase the surgical difficulties of complete enucleation and lead to potential mucosal damage. Moreover, a subtotal esophagectomy cannot be avoided in some conditions. Here, we report the first case of robot-assisted enucleation of a large dumbbell-shaped esophageal schwannoma.Case Presentation: A 48-year-old woman presenting with a 1-year history of dysphagia was noted to have a homogeneous irregular mass measuring 70 mm in diameter and arising from the submucosal layer of the distal esophagus. A diagnosis of an esophageal submucosal tumor (SMT) was made, most likely leiomyoma. Robot-assisted thoracoscopic excision of the tumor was performed. The da Vinci Surgical System provided delicate dissection in the confined posterior mediastinal space, and the large dumbbell-shaped tumor was completely removed without damage to the mucosal integrity. The operative time was 108 min, and the blood loss was less than 20 ml. The pathology of the tumor was esophageal schwannoma. The patient experienced an unremarkable recovery and was discharged on the fifth day after operation. No symptoms or recurrence were present at the 50-month follow-up postoperatively.Conclusion: We present a rare case of large irregular esophageal schwannoma that was excised by robot-assisted surgery. A clear operative field and delicate dissections are critical points for the complete removal of this large esophageal SMT. We demonstrate that robotic treatment of large esophageal schwannoma is minimally invasive and can be successfully applied in such cases. [ABSTRACT FROM AUTHOR]

Esophageal schwannoma is a rare tumor first described in 1967 by Chaterlin and Fissore. These tumors are most commonly found incidentally or from diagnostic work up of dysphagia or dyspnea. This entity cannot be diagnosed on clinical or radiographic basis alone. Histology demonstrates palisading spindle cells, few if any mitotic figures, and a peripheral cuff of lymphoid cells. Immunohistochemically, tumor cells stain positive for S100, a characteristic marker of Schwann cells. Once diagnosed, surgical enucleation is the typical treatment method employed. [ABSTRACT FROM AUTHOR]

Esophageal schwannomas are rarely observed, and the most frequent presenting symptom is dysphagia. In such cases, esophageal endoscopy shows a mucosal protrusion with normal esophageal mucosa. Esophagography shows a protruding smooth mass in the middle thoracic esophagus. Both fluorodeoxyglucose (FDG) positron emission tomography (PET) and endoscopic ultrasonography-fine needle aspiration (EUS-FNA) are limited for diagnosing the case. Diagnosis of this condition before surgery is difficult. The most common and effective treatment is enucleation through surgery or endoscopy. Thoracoscopic surgery is gradually becoming used more often, and the prognosis is particularly good. In comparison, thoracoscopy surgery is less invasive, with a shorter length of hospital stay, and reduced pain at the surgical wound site. Extended lymph node dissection was not performed. The positive expression of S-100 on immunohistochemistry examination indicates the nature of the schwannoma. In the present cases, the postoperative course was uneventful, and no evidence of recurrence has been noted.