Abstract
A 70-year-old female was admitted to our hospital for close examinations of an esophageal submucosal tumor. Chest computed tomography showed a soft tissue tumor 60 mm in longer diameter at the cervical and upper intrathoracic esophagus. Upper gastrointestinal endoscopy revealed a submucosal tumor at a point where was 25 cm apart from the incisors. We performed the endoscopic ultrasonography-guided fine needle aspiration biopsy (EUS-FNA). A histopathological examination of the biopsy specimen showed increased eosinophilic spindle-shaped cells, and gastrointestinal stromal tumor (GIST) was strongly suggested by immunohistochemical staining. FDG-PET scan showed high uptake of FDG in the tumor with the SUVmax of 9.9, and it was diagnosed as submucosal tumor including malignant GIST. We performed subtotal esophagectomy accompanied with gastric role reconstruction. An immunohistochemical staining of the tumor showed the positive reaction for S-100 and the negative reaction for desmin, αSMA, CD34, KIT and DOG1. The Ki-67 index was less than1%. Hence, the final diagnosis was made as an esophageal schwannoma.
Leiomyoma is the most common submucosal tumor of the esophagus and schwannoma is rare. There have been few reports of benign esophageal schwannoma in which FDG-PET scan was conducted. We herein report this case with a review of the previous reports.
