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Strategy for esophageal non-epithelial tumors based on a retrospective analysis of a single facility

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Abstract

Background

Although most esophageal non-epithelial tumors are benign tumors, such as leiomyomas, they also include gastrointestinal tumors (GISTs); thus, a histopathological diagnosis is indispensable to determine the optimal treatment strategy. However, no consensus has been reached as to the diagnostic methods and treatments for esophageal non-epithelial tumors. The purpose of this study was to evaluate the reliability of the diagnostic methods and treatments for esophageal non-epithelial tumors in our hospital.

Methods

All 28 cases of esophageal non-epithelial tumors at Kobe University Hospital from 2008 to 2016 were analyzed retrospectively with respect to the diagnostic methods, histopathological diagnosis, and treatments.

Results

Three diagnostic methods, endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA), endoscopic incisional biopsy, and endoscopic submucosal dissection (ESD)/endoscopic mucosal resection (EMR), were performed in our hospital. All GIST cases could be correctly diagnosed by EUS-FNA. Tumors less than approximately 20 mm in diameter and located in the superficial layer are good indications for ESD/EMR, which both play roles in diagnosis and treatment. The final diagnoses by these methods consisted of the following: 13 leiomyomas, 5 GISTs, 3 schwannomas, 2 liposarcomas, 3 cysts, 1 reactive lymphoid hyperplasia, and 1 granulosa cell tumor. Fifteen cases underwent surgery. Enucleation or partial resection was performed for leiomyomas, schwannomas and liposarcomas, while esophagectomy was performed for GISTs. Thus, sufficient management of non-epithelial tumors is achieved.

Conclusions

Improved endoscopic procedures, including EUS-FNA and ESD/EMR, enabled the appropriate diagnosis and treatment of esophageal non-epithelial tumors.

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Authors and Affiliations

  1. Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Tomoaki Aoki, Tetsu Nakamura, Taro Oshikiri, Hiroshi Hasegawa, Masashi Yamamoto, Yoshiko Matsuda, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Yasuo Sumi, Satoshi Suzuki & Yoshihiro Kakeji

  2. Division of International Clinical Cancer Research, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Yasuo Sumi

Authors
  1. Tomoaki Aoki
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  2. Tetsu Nakamura
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  3. Taro Oshikiri
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  4. Hiroshi Hasegawa
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  5. Masashi Yamamoto
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  6. Yoshiko Matsuda
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  7. Shingo Kanaji
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  8. Kimihiro Yamashita
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  9. Takeru Matsuda
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  10. Yasuo Sumi
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  11. Satoshi Suzuki
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  12. Yoshihiro Kakeji
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Corresponding author

Correspondence to Tomoaki Aoki.

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Consent for publication

Written informed consent for this publication and the use of the accompanying images was obtained from all patients. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Ethical Statement

All procedures and subsequent analyses were performed with the approval of the Clinical & Translational Research Center of Kobe University Hospital in Japan. The study was conducted in accordance with the guidelines of the 1975 Declaration of Helsinki, as revised in 2000 (5), concerning Human and Animal Rights. Written informed consent was obtained from all subjects.

Conflict of interest

The authors have no conflicts of interest and received no financial support for this study.

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Aoki, T., Nakamura, T., Oshikiri, T. et al. Strategy for esophageal non-epithelial tumors based on a retrospective analysis of a single facility. Esophagus 15, 286–293 (2018). https://doi.org/10.1007/s10388-018-0628-6

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  • DOI: https://doi.org/10.1007/s10388-018-0628-6

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