BACKGROUND Esophageal schwannomas originating from Schwann cells are extremely rare esophageal tumors.They commonly occur in the upper and middle esophagus but less frequently in the lower esophagus.Herein,we report a...BACKGROUND Esophageal schwannomas originating from Schwann cells are extremely rare esophageal tumors.They commonly occur in the upper and middle esophagus but less frequently in the lower esophagus.Herein,we report a rare case of a large lower esophageal schwannoma misdiagnosed as a leiomyoma.We also present a brief literature review on lower esophageal schwannomas.CASE SUMMARY A 62-year-old man presented with severe dysphagia lasting 6 mo.A barium esophagogram showed that the lower esophagus was compressed within approximately 5.5 cm.Endoscopy revealed the presence of a large submucosal protuberant lesion in the esophagus at a distance of 32-38 cm from the incisors.Endoscopic ultrasound findings demonstrated a 4.5 cm×5.0 cm hypoechoic lesion.Chest computed tomography revealed a mass of size approximately 53 mm×39 mm×50 mm.Initial tests revealed features indicative of leiomyoma.After multidisciplinary discussions,the patient underwent a video-assisted thoracoscopic partial esophagectomy.Further investigation involving immunohistochemical examination confirming palisading spindle cells as positive for S100 and Sox10 led to the final diagnosis of a lower esophageal schwannoma.There was no tumor recurrence or metastasis during follow-up.CONCLUSION The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination.The early appropriate surgery favors a remarkable prognosis.展开更多
BACKGROUND Submucosal hematoma(SH)is one of the rare causes of upper gastrointestinal bleeding.As a rare and critical disease in clinical practice,it should be paid more attention to by clinicians to avoid missed diag...BACKGROUND Submucosal hematoma(SH)is one of the rare causes of upper gastrointestinal bleeding.As a rare and critical disease in clinical practice,it should be paid more attention to by clinicians to avoid missed diagnosis and misdiagnosis.Most of the esophageal submucosal hematomas have clear causes,including retrosternal pain,dysphagia,etc.Here,we report a rare case of SH extending from the hypopharynx to the lower esophagus caused by oral administration of hirudin and panax notoginseng powder,with atypical clinical manifestation.Such a long submucosal hematoma has rarely been reported.CASE SUMMARY The patient was a 60-year-old male with a history of gastritis,hypertension,coronary heart disease,and coronary stent implantation.The patient developed chest tiredness and heartburn after taking 10 capsules of a homemade mixture of hirudin and notoginseng powder in the previous 2 d.He did not have hematemesis or black stool.Gastroscopy and chest computed tomography confirmed the diagnosis of SH,which ranged from the pharynx to the lower esophagus and was 35-40 cm in length.After the diagnosis was confirmed,we performed active conservative treatment on the patient,and the patient recovered well and remained asymptomatic during the 26-mo follow-up.CONCLUSION SH is rare,and cases with atypical clinical symptoms may lead to misdiagnosis and missed diagnosis.Ignorance of this disease can lead to serious clinical consequences.Conservative therapy is effective and the prognosis is good.展开更多
基金Supported by National Natural Science Foundation of China,No.81770525.
文摘BACKGROUND Esophageal schwannomas originating from Schwann cells are extremely rare esophageal tumors.They commonly occur in the upper and middle esophagus but less frequently in the lower esophagus.Herein,we report a rare case of a large lower esophageal schwannoma misdiagnosed as a leiomyoma.We also present a brief literature review on lower esophageal schwannomas.CASE SUMMARY A 62-year-old man presented with severe dysphagia lasting 6 mo.A barium esophagogram showed that the lower esophagus was compressed within approximately 5.5 cm.Endoscopy revealed the presence of a large submucosal protuberant lesion in the esophagus at a distance of 32-38 cm from the incisors.Endoscopic ultrasound findings demonstrated a 4.5 cm×5.0 cm hypoechoic lesion.Chest computed tomography revealed a mass of size approximately 53 mm×39 mm×50 mm.Initial tests revealed features indicative of leiomyoma.After multidisciplinary discussions,the patient underwent a video-assisted thoracoscopic partial esophagectomy.Further investigation involving immunohistochemical examination confirming palisading spindle cells as positive for S100 and Sox10 led to the final diagnosis of a lower esophageal schwannoma.There was no tumor recurrence or metastasis during follow-up.CONCLUSION The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination.The early appropriate surgery favors a remarkable prognosis.
基金Supported by Shandong Province Medical and Health Science and Technology Development Plan(Clinical Study of Minimally Invasive Treatment Under Endoscopy of Gastrointestinal Mucosa),No.2016WS0124.
文摘BACKGROUND Submucosal hematoma(SH)is one of the rare causes of upper gastrointestinal bleeding.As a rare and critical disease in clinical practice,it should be paid more attention to by clinicians to avoid missed diagnosis and misdiagnosis.Most of the esophageal submucosal hematomas have clear causes,including retrosternal pain,dysphagia,etc.Here,we report a rare case of SH extending from the hypopharynx to the lower esophagus caused by oral administration of hirudin and panax notoginseng powder,with atypical clinical manifestation.Such a long submucosal hematoma has rarely been reported.CASE SUMMARY The patient was a 60-year-old male with a history of gastritis,hypertension,coronary heart disease,and coronary stent implantation.The patient developed chest tiredness and heartburn after taking 10 capsules of a homemade mixture of hirudin and notoginseng powder in the previous 2 d.He did not have hematemesis or black stool.Gastroscopy and chest computed tomography confirmed the diagnosis of SH,which ranged from the pharynx to the lower esophagus and was 35-40 cm in length.After the diagnosis was confirmed,we performed active conservative treatment on the patient,and the patient recovered well and remained asymptomatic during the 26-mo follow-up.CONCLUSION SH is rare,and cases with atypical clinical symptoms may lead to misdiagnosis and missed diagnosis.Ignorance of this disease can lead to serious clinical consequences.Conservative therapy is effective and the prognosis is good.
