Total removal of a large esophageal schwannoma by submucosal tunneling endoscopic resection:A case report and review of literature

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.

Imaging features of retinal hemangioblastoma:A case report

BACKGROUND Hemangioblastoma typically occurs in the cerebellum,spinal cord,and central nervous system.However,in rare cases,it could occur in the retina or optic nerve.The prevalence of retinal hemangioblastoma is 1 in 73080,and it occurs either alone or as the manifestation of von Hippel Lindau(VHL)disease.Here,we reported a rare case with the imaging features of retinal hemangioblastoma without VHL syndrome,along with the relevant literature review.CASE SUMMARY A 53-year-old man had progressive swelling,pain and blurred vision in the left eye without obvious inducement for 15 d.Ultrasonography revealed a possible optic nerve head melanoma.Computed tomography(CT)showed punctate calcification on the posterior wall of the left eye ring and small patchy soft tissue density in the posterior part of the eyeball.Magnetic resonance imaging showed slightly hyperintense signal on T1-weighted images and slightly hypointense-toisointense signal on T2-weighted images at the medial and posterior edges of the left eyeball,a significant enhancement was observed in the contrast-enhanced scans.Positron emission tomography/CT fusion images showed that the glucose metabolism of the lesion was normal.Pathology was consistent with hemangioblastoma.CONCLUSION Early identification of retinal hemangioblastoma based on imaging features is of great value for its personalized treatment.

Asymptomatic traumatic rupture of an intracranial dermoid cyst:A case report

BACKGROUND Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous,and only a few were traumatic,with asymptomatic much rarer than the symptomatic ruptures.Hence,how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic.CASE SUMMARY A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography(CT)scan due to a car accident.A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa,accompanied with lipid droplet drifts in brain sulci,fissures,cisterns,and ventricles.After 1 wk of conservative observation,no change was observed on the updated cranial CT scan.After 2 wk of conservative observation,magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts.As the patient exhibited no adverse symptoms throughout the 2 wk,a 6-mo follow-up visit was arranged for him instead of aggressive treatment.Nonetheless,the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits.CONCLUSION Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively.

Interhemispheric functional connectivity for Alzheimer's disease and amnestic mild cognitive impairment based on the triple network model

The purpose of this study was to explore the differences in interhemispheric functional connectivity in patients with Alzheimer’s disease(AD) and amnestic mild cognitive impairment(aMCI) based on a triple network model consisting of the default mode network(DMN), salience network(SN), and executive control network(ECN). The technique of voxel-mirrored homotopic connectivity(VMHC) analysis was applied to explore the aberrant connectivity of all patients. The results showed that:(1) the statistically significant connections of interhemispheric brain regions included DMN-related brain regions(i.e. precuneus, calcarine, fusiform, cuneus, lingual gyrus, temporal inferior gyrus, and hippocampus), SN-related brain regions(i.e. frontoinsular cortex), and ECN-related brain regions(i.e. frontal middle gyrus and frontal inferior);(2) the precuneus and frontal middle gyrus in the AD group exhibited lower VMHC values than those in the aMCI and healthy control(HC) groups, but no significant difference was observed between the a MCI and HC groups; and(3) significant correlations were found between peak VMHC results from the precuneus and Mini Mental State Examination(MMSE) and Montreal Cognitive Scale(MOCA) scores and their factor scores in the AD, a MCI, and AD plus aMCI groups, and between the results from the frontal middle gyrus and MOCA factor scores in the a MCI group. These findings indicated that impaired interhemispheric functional connectivity was observed in AD and could be a sensitive neuroimaging biomarker for AD. More specifically, the DMN was inhibited, while the SN and ECN were excited. VMHC results were correlated with MMSE and MOCA scores, highlighting that VMHC could be a sensitive neuroimaging biomarker for AD and the progression from aMCI to AD.