Abstract
Esophageal submucosal tumors (SMTs) including schwannoma are rare and we have great difficulties in diagnosing them preoperatively in many cases. The usefulness of thoracoscopic esophagectomy in the prone position has been demonstrated in these days, but there are very few reports of left thoracoscopic resection of esophageal tumors. We describe a case of an esophageal schwannoma performed left thoracoscopic resection in the prone position. A 65-year-old woman complaining of epigastric pain was found to have a 6-cm esophageal SMT on esophagogastroduodenoscopy. A chest CT scan revealed a 55 × 38 mm tumor with the homogeneous center on the left wall of the mid-to-lower thoracic esophagus. The tumor was diagnosed with schwannoma by a fine needle aspiration biopsy under endoscopic ultrasonography (EUS-FNAB) and immunohistochemistry. She underwent left thoracoscopic enucleation of the tumor in the prone position, because the tumor was localized in the left wall of mid-to-lower esophagus. The operative time was 207 min and the operative blood loss was 3 g. The postoperative course was uneventful and she was discharged on the 8th postoperative day. Because preoperative diagnosis decides operative methods for esophageal SMTs, we should carry out EUS-FNAB which ensures a high correct diagnosing rate. Left thoracoscopic approach in the prone position is beneficial for enucleation of SMTs locating in the left side of the esophageal wall below the aortic arch.
