Malignant schwannoma of the esophagus with lymph node metastasis: Literature review of schwannoma of the esophagus

An extremely rare case of malignant schwannoma of the esophagus with lymph node metastasis is reported. A 49-year-old woman was found to have an abnor mal shadow on a chest X-ray film taken during an annual checkup. Upper gast rointestinal series showed extrinsic pressure on the middle thoracic esopha gus, without a mucosal lesion. An exploratory operation was performed. with a tentative diagnosis of esophageal leiomyoma. The tumor was enucleated wi th part of the esophageal mucosa. and a few enlarged lymph nodes around the tumor were dissected. The resected tumor was an elastic firm mass, measuri ng 8.2 x 5.8 x 3.7 cm. and had a smooth surface. Histological examination o f the tumor revealed the proliferation of spindle-shaped cells with chromat in-rich nuclei. The nuclei were variable in size and showed remarkable atyp ia. A paraesophageal lymph node had same findings as the main tumor. Immuno histochemically. the tumor cells were diffusely positive for S-100 protein and neuron-specific enolase. The pathological diagnosis of this tumor was m alignant esophageal schwannoma with lymph node metastasis. Esophageal schwa nnoma is extremely rare. We reviewed the literature on 19 cases of esophage al schwannoma, including that in our patient. The majority of the tumors we re benign. Only three cases of schwannoma were malignant, and this is the f irst reported case of malignant schwannoma with lymph node metastasis.