[Differential diagnosis and treatment of esophageal stromal tumors and smooth muscle tumors].
OBJECTIVE
Esophageal stromal tumors and smooth muscle tumors are not easy to be distinguished in clinic though they have different pathologic features. This study was to compare the clinicopathologic features of esophageal stromal tumors and smooth muscle tumors, and discuss their treatments.


METHODS
The expression of CD117 and CD34 in 16 specimens of primarily diagnosed esophageal leiomyoma, 4 specimens of esophageal leiomyosarcoma, and 1 specimen of stromal tumor was detected by immunohistochemistry. The clinicopathologic features of the patients were analyzed, and the treatment principles and curative efficacies were summarized.


RESULTS
Of the 16 cases of primarily diagnosed esophageal leiomyoma, 5 were CD117(+) and finally diagnosed as non-high aggressive fatal stromal tumor according to the assessment criteria of stromal tumors; 11 were CD117(-). The stromal tumor was CD117(+) and CD34(+), and diagnosed as high aggressive fatal stromal tumor. The 4 cases of primarily diagnosed esophageal leiomyosarcoma were CD117(-) and CD34(-). There was no obvious difference in clinicopathologic manifestations, treatment and prognosis between esophageal non-high aggressive fatal stromal tumor and leiomyoma, and between esophageal high aggressive fatal stromal tumor and leiomyosarcoma.


CONCLUSIONS
Esophageal stromal tumors and smooth muscle tumors can not be distinguished with clinicopathologic exhibitions. The immunohistochemical examination of antibody CD117 is necessary for identifying them. Lumpectomy or esophageal partial resection is enough for esophageal non-high aggressive fatal stromal tumor and leiomyoma. Esophageal partial resection is necessary for esophageal high aggressive fatal stromal tumor and leiomyosarcoma.
Zhang
Xu
X
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China. zsyzhangxu@163.com
Rong
Tie-Hua
TH
Wu
Qiu-Liang
QL
Fu
Jian-Hua
JH
Long
Hao
H
Zhang
Lan-Jun
LJ
Ma
Guo-Wei
GW
Su
Xiao-Dong
XD
Li
Xiao-Dong
XD
Wang
Dao-Feng
DF
Hu
Yi
Y
Yang
Hong
H
D000199:Actins / Q000378:metabolism; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D007890:Leiomyosarcoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016900:Neurofilament Proteins / Q000378:metabolism; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism*
D000199:Actins; D018952:Antigens, CD34; D016900:Neurofilament Proteins; D019009:Proto-Oncogene Proteins c-kit