Two cases of esophageal submucosal tumor treated by thoracoscopic enucleation

Yusuke Nakagawa, Katuhiro Tomofuji, Tomoyuki Nagaoka, Tomoaki Okada, Tatuo Yamauti, Naoki Isida, Yoshinori Imai, Taro Nakamura, Hidenori Kiyoti, Kennzou Okada, Sinsuke Kajiwara. uwajima city hospital

We reported two cases of esophageal submucosal tumor treated by thoracoscopic enucleation.

Case 1 is that of a 61-year-old woman who was refered to our hospital for examination of a posterior mediastinal tumor by computed tomography. An esophageal submucosal tumor was suspected,and we planned thoracoscopic enucleation with the patient in a prone position.Following esophagomyotomy,the tumor was enucleated, and the esophageal muscle layer was sutured thoracoscopically .Pathological analysis revealed a 47mm×37mm,low risk gastrointestinal stromal tumor(GIST).The postoperative course went well.

Case 2 is that of a 66-year-old woman who was refered to our hospital because of abnormal findings on gastrointestinal endoscopy.We diagnosed the patient as having submucosal tumor in the lower thoracic esophagus,and thoracoscopic surgery was performed uing the same procedure described in case 1.Pathological analysis revealed a 34mm×29mm,schwannoma. The postoperative course was uneventful.

The majority of esophageal neoplasms are carcinomas, and esophageal mesenchymal tumors are rare. As a result, no standard surgical indication or procedure has been established for esophageal submucosal tumors. Tumor enucleation is not commonly recommended because of the risk of tumor dissemination.However,given the high risk of tumor invasion of following esophageal resection,enucleation of small-sized or pathologically low risk esophageal submucosal tumors is considered acceptable.

Leiomyoma is generally assumed to be the predominant type of esophageal submucosal tumor,and,GIST and schwannoma are extremely rare.Surgery is the first-line treatment for both tumors.We performed less invasive thoracoscopic enucleation for both cases.Thoracoscopic enucleation is a safe and feasible for treatment of esophageal submucosal tumors.

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