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Clinicopathological features of esophageal schwannomas in mainland China: systematic review of the literature

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Abstract

Objective

Esophageal schwannoma (ES) are rare and mostly benign neurogenic tumors. The clinical misdiagnosis rate of it is high. In this study, the clinicopathologic features of ES in mainland China were studied to better understand the disease and improve the diagnosis and treatment rate.

Methods

A systematic review was conducted in accordance with PRISMA guidelines. The keywords "esophageal schwannoma", "esophageal neurinoma" and "esophageal neurilemoma" were searched for databases such as Pubmed, EMbase, Wanfang Database and Chinese National Knowledge Infrastructure. The search time frame for database was until July 2019. Combined with our patient, the clinicopathological data and the diagnosis and treatment of ES were summarized.

Results

ES occurs in the upper part of the mediastinum and in the thoracic esophagus in most patients in the neck, upper and middle segments. CT and PET/CT examinations can be used for diagnosis, but the differentiation value of both benign and malignant ES is similar. The histopathological findings of forceps biopsy specimens are often difficult to diagnose, and deep tissue biopsies may increase pathological accuracy. EUS-FNA is also recommended for ES diagnosis, but it may also be misdiagnosed. Pathological features include a fusiform arrangement in a palisade-like structure or a tumor cell arranged in a network to form a loose structure. ES characteristic immunohistochemistry results showed that S-100 protein has strong immunological activity.

Conclusion

The definitive diagnosis requires immunohistochemistry, especially immunological reaction with S-100 protein. The appropriate treatment plan should be selected according to the diameter of the lesion. The overall prognosis of ES is good, but attention should be paid to follow-up.

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Availability of data and materials

All data generated or analyzed during this study are included in this article and its supplementary information files.

Abbreviations

ES:

Esophageal schwannoma

EGD:

Esopghagogastroduodenoscopy

EUS:

Endoscopic ultrasound

MP:

Muscularis propria

ESD:

Endoscopic submucosal dissection

CT:

Computed tomography

PET/CT:

Positron emission tomography/computed tomography

STER:

Submucosal tunneling endoscopic resection

SMT:

Submucosal tumors

EUS-FNA:

Endoscopic ultrasonography-guided fine needle aspiration

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Acknowledgements

We sincerely thank all the authors and study participants for their support in this study.

Funding

This study was funded by Scientific research project of Hubei Provincial Department of Education (Q20102112), Shiyan City Science and Technology Bureau Guiding Research Project (19Y44) and the Foundation of Taihe Hospital (2019JJXM032).

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  1. Zi-ye Gao and Xiao-bo Liu equal contributors.

Authors and Affiliations

  1. Department of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China

    Zi-ye Gao

  2. Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, 32 South Renmin Road, Shiyan, 442000, Hubei, People’s Republic of China

    Xiao-Bo Liu, Sandeep Pandey, Qing-hui Zhang, Yuan-Jun Gao & Sheng-Bao Li

  3. Post Graduate Department, Hubei University of Medicine, Shiyan, 442000, Hubei, China

    Sandeep Pandey

  4. Department of Laboratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China

    Bo Gao

  5. Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China

    Ping Liu

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Contributions

Z-YG, X-BL, and S-BL conceived and designed this study. Z-YG and X-BL searched and collected the data. X-BL, SP, and Q-HZ contributed to data extraction and data analysis. X-BL and BG wrote the manuscript. SP, PL, and S-BL reviewed and revised the paper. X-BL, Y-JG, and S-BL approved and submitted the final manuscript. All authors read, and approved the final manuscript and its submission.

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Correspondence to Yuan-Jun Gao or Sheng-Bao Li.

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Gao, Zy., Liu, XB., Pandey, S. et al. Clinicopathological features of esophageal schwannomas in mainland China: systematic review of the literature. Int J Clin Oncol 26, 284–295 (2021). https://doi.org/10.1007/s10147-020-01809-4

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