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 4th 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.
