TUNNEL DISSECTION FOR ESOPHAGEAL GLOMUS TUMOR

Our patient, a 67-year old male, presented with a long history of COPD. Regular thoracic CT revealed a tumor in esophagus arising from the lateral posterior wall, measuring 3.0*2.0*2.7 cm, with mediastinal lymphadenopathy. Endoscopy with ultrasound showed a mass in the proximal third of the esophagus, of heterogenous structure, arising from 4^th layer. The initial impression was that of a gastrointestinal stromal tumor. However, there were too many doubts.

He was then scheduled for a total biopsy via endoscopic tunnel access. The mass was successfully removed through the esophagus. The tumor, 27 × 25 × 23 mm in size, was composed of epithelioid cells with rounded small nuclei and eosinophilic cytoplasm. The mitotic figures were scarce [3/50 high-power fields (HPF)]. Immunohistochemically, the tumor cells were moderately positive for α-SMA, muscle-specific actin (MSA); positive for synaptophysin and CD56 (weakly); negative for CD34, CD117, DOG1, desmin, HMB45, chromogranin A, melan A and S-100 protein. Ki-67 was from 2 to 10%. This features suggested glomus tumor.

The patient had an uncomplicated postoperative course and was discharged from the hospital 2 days after surgery. He remains healthy without any recurrence to date two months after surgery.