Esophageal schwannoma treated by transthoracic esophagectomy: A case report

We report the case of a 72-year-old man with esophageal schwannoma who underwent the Ivor Lewis procedure. He suffered from dysphagia for 6 months. Esophagoscopy revealed a submucosal tumor bulging on the posterior wall 30cm distant from the incisors. Endoscopic ultrasonography (EUS) revealed tumor located within the muscularis propria, the fourth layer of the esophageal wall. Upper gastrointestinal series showed an elevated lesion, 6 cm in diameter, on the posterior wall of the upper thoracic esophagus. These findings were suggestive of leiomyosarcoma. The area of esophagus including the tumor was resected using the Ivor Lewis procedure. The tumor was 5.5 4.5 4.5cm in size, with a smooth surface that was elastic and firm. Histological examination revealed spindle-shaped cells with oval nuclei, and Antoni A and B types coexisted in the tumor tissue. Immunohistochemical studies yielded positive results for S-100 protein and negative results for CD34, desmin, and α-smooth muscle actin. A diagnosis of esophageal schwannoma was established. He was discharged from the hospital and has been doing well with no recurrence for 20 months after surgery. © Japan Esophageal Society and Springer-Verlag 2004.