A case of malignant peripheral nerve sheath tumor of the esophagus treated by thoracoscopic esophagectomy

TESHIMA Jin, KAMEI Takashi, MITAMURA Atsushi, NAKAMURA Takanobu, SATOMI Susumu

doi:10.3919/jjsa.73.1924

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胸腔鏡下食道切除を行った食道悪性末梢神経鞘腫の1例
ショウレイキョウコウキョウカショクドウセツジョオオコナッタショクドウアクセイマッショウシンケイサヤシュノ 1レイ

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Abstract

We report an extremely rare case of malignant peripheral nerve sheath tumor (MPNST) of the esophagus. A 64-year-old woman was found to have enlargement of the ascending aorta on a chest X-ray film taken during an annual checkup. A chest computed tomography (CT) showed a posterior mediastinal tumor, 80×75×40 mm in size and suspected to be a neurogenic tumor based on an endoscopic ultrasound-guided fine-needle aspiration biopsy. Thoracoscopic esophagectomy was performed, and reconstructed by a gastric-tube using the posterior mediastinal route. The tumor was composed of spindle cells with palisaded and steriform patterns. The tumor cells were diffusely positive for S-100 protein, but negative for c-kit, desmin, CD34, and αSMA. We diagnosed low grade esophageal MPNST because the Ki-67 index was 8%. Metastasis was not detected in the regional lymph nodes. The patient has survived for two years with no sign of recurrence. Long term prognosis of esophageal MPNST is unknown, so careful follow-up is needed in the future.

Journal

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 73 (8), 1924-1928, 2012

Japan Surgical Association

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