Esophageal Schwannoma-Systematic Review of Clinicopathologic Factors and Treatment

Background: Esophageal schwannomas are extremely rare, benign mesenchymal tumors originating from the nerve sheath tissues of autonomic nerves, accounting for less than 2% of all esophageal tumors. This systematic review aims to provide a detailed analysis of esophageal schwannomas (ESs), focusing on tumor characteristics, diagnostic methods, and treatment options. Methods: A systematic search of English literature databases, including ScienceDirect, Springer, PubMed, and Google Scholar, was conducted up to 2023. The keywords used were 'esophageal schwannoma,' 'gastrointestinal schwannoma,' 'esophageal neurinoma,' and 'esophageal neurilemoma.' Studies were reviewed for patient demographics, clinical presentation, diagnostic methods, tumor characteristics, and management options. Results: A total of 370 articles met the inclusion criteria, with 80 articles (89 cases) included in the final analysis. The mean age of patients was 51.8 years, with a female predominance (73%). Most cases were reported from East Asia (60.7%). Most (71%) patients presented with dysphagia, and 12% were asymptomatic. Preoperative diagnosis often involved CT scans (75.28%), upper endoscopy (73.03%), and EUS (49.4%). Tumors averaged 77.86 mm in size as per CT, MRI and PET-CT, with the upper esophagus being the most common location (55.55%). Surgical resection was the primary treatment, with enucleation being the most frequent procedure (58.9%). The prognosis was generally excellent, with no reported recurrences during follow-up periods. Conclusions: Esophageal schwannomas are extremely rare. Surgical resection remains the treatment of choice, with a high success rate and excellent prognosis. Further studies are needed to standardize diagnostic and treatment protocols for these rare tumors.