A Case of Esophageal Schwannoma with Lymphadenopathy Diagnosed Preoperatively Using EUS-FNA and Treated with Enucleation

Abstract

A 59-year-old woman visited our hospital complaining of a cough. A chest computed tomography (CT) examination revealed a 55×30-mm tumor and lymph node swelling (106 recL). Positron emission tomography (PET)-CT studies showed a high uptake of fluorodeoxyglucose (FDG) in the tumor and the 106 recL lymph node. An upper gastrointestinal endoscopy revealed a submucosal tumor located at a point 18-27 cm from the incisors. Endoscopic ultrasonography-guided fine needle aspiration biopsy (EUS-FNA) of the tumor revealed a cluster of spindle-shaped cells. Immunohistochemical staining of the specimen showed a positive reaction for S-100 and negative reactions for CD34, c-kit, and SMA. We diagnosed the tumor as an esophageal schwannoma. We performed tumor enucleation thorough a thoracotomy after intraoperatively confirming the absence of malignant cells in the 106 recL lymph node by frozen section analysis. Immunohistochemical examination of the tumor revealed a positive reaction for S-100 and low levels of Ki-67 expression. Hence, the final diagnosis was benign esophageal schwannoma. Here, we report a case of esophageal schwannoma with lymph node swelling that was diagnosed preoperatively using EUS-FNA and that was removed by enucleation.