Thoracoscopic Enucleation of Esophageal Submucosal Tumor

Special Article - Surgical Case Reports

Austin J Surg.2017; 4(1): 1096.

Thoracoscopic Enucleation of Esophageal Submucosal Tumor

Wu MH* and Wu HY

Department of Surgery, Tainan Municipal Hospital,Taiwan

*Corresponding author: Ming-Ho Wu, Department of Surgery, Tainan Municipal Hospital, Taiwan

Received: January 19, 2017; Accepted: February 17, 2017; Published: February 22, 2017

Abstract

Preoperative diagnosis and surgical approach are critical points in the management of posterior mediastinal lesions. A 77 year-old woman with esophageal submucosal tumor underwent thoracoscopic enucleation of the tumor. Clinically, she presented with dysphagia and epigastric discomfort. The patient was uneventful discharged on postoperative day 3. Postoperative esophagography showed normal patency. Perioperative images are interest.

Keywords: Esophageal submucosal tumor; Thoracoscopic excision; Mediastinal bronchogenic cyst

Introduction

Esophageal submucosal tumor could locate at any area of whole course of the esophagus [1]. The disease usually present with dysphagia that resulted from tumor compression of the esophagus. Here, we present a patient with a 3.6 cm esophageal submucosal tumor. The patient underwent thoracoscopic enucleation of the tumor. We will focus on the thoracoscopic enucleation and perioperative images.

Case Presentation

A 77-year-old woman complained of dysphagia and epigastric discomfort for more than 3 months. Chest film showed normal airways. Esophagography showed submucosal defect at lower thoracic esophagus (Figure 1). Endoscopy revealed a submucosal lesion located at lower thoracic esophagus (Figure 2). Contrast computed tomography revealed a 3.6 cm heterogeneous density bulging mass at the lower esophagus (Figure 3). The surgical procedure was as following; a 4 cm incision was made at left 5th intercostal space of middle axillary line and a port at left 9th intercostal space of posterior axillary line. A 3.6 cm lesion in the lower third esophageal submucosa was carefully dissected free from the adjacent tissue (Figure 4). Operation time was 60 minutes. Histology was proved to be esophageal submucosal gastrointestinal stromal tumor. Postoperative esophagography showed normal patency (Figure 5).