Application of a hybrid approach to the removal of large esophageal schwannoma

Abstract

Introduction. Esophageal schwannoma is a rare spindle cell tumor derived from Schwann cells. To date, only 17 cases of esophageal schwannoma have been reported, with most of them occurring in women over the age of 50 years. Surgical interventions using open (cervical approach, extirpation of the esophagus with simultaneous plasty of the gastric tube) and thoracoscopic approaches have long been considered standard methods of treating patients with nonepithelial tumors of the esophagus, but currently minimally invasive endoscopic interventions are widely used. Clinical case. The patient, 64 years old, was treated at the Vishnevsky National Research Medical Center for Surgery for a large schwannoma of the esophagus. Results. This article presents a rare clinical observation - removal of a large schwannoma of the esophagus using a hybrid approach. During a control endoscopic examination 4 months after surgery, no signs of residual tumor fragments, narrowing or pathological changes in the mucosa were found in the area of the previously performed dissection. Conclusion. The use of a hybrid approach for removing a large non-epithelial tumor of the esophagus using endoscopic dissection in the submucosal layer and subsequent extraction through the cervical approach made it possible to perform organ-saving surgery, minimize the risks of possible intraoperative and postoperative complications, thereby leading to a good clinical and functional result.