PMC4391505_01
Transnasal gastroscopy. A submucosal tumor (arrow) of approximately 2 cm is visible at the 9 o'clock position in the lower esophagus, 41 cm from the tip of the nose. The surface of the tumor is smooth, and all the findings indicate gastrointestinal stromal tumor.
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Gastroscopy performed at our hospital revealed a submucosal tumor with a smooth surface at the 9 o'clock position in the lower esophagus (Figure 1).
Barium esophagography. The image reveals extrinsic compression by a mass with a smooth surface (arrow) in the intra-abdominal esophageal region. Extension of the esophageal wall was good.
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Barium esophagogram showed extrinsic compression from the lower esophagus to the gastroesophageal junction (Figure 2).
Endoscopic ultrasonography. The image shows a cystic mass extending from the lower esophagus to the cardiac region of the stomach and is filled with viscous components. No echoic debris indicative of bleeding or solid components was observed.
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Endoscopic ultrasonography showed a cystic mass in the esophageal wall extending from the lower esophagus to the cardiac region of the stomach (Figure 3), with the suspected presence of viscous fluid inside the cyst.
Computed tomography. The images reveal a dumbbell-shape iso-enhanced mass with a smooth surface, which extends parallel to the esophagus and spreads over and below the esophageal hiatus.
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Computed tomography (CT) showed an iso-enhanced dumbbell-shaped mass (3.5 x 3 cm) with a smooth surface and homogeneous content, which extended from the lower thoracic esophagus to the cardiac region of the stomach (Figure 4).
Magnetic resonance imaging. The images reveal a cystic mass extending from the lower esophagus to the cardiac region of the stomach. The mass appears to be located in or even outside the muscular layer and may contain mucin, high protein fluid, or blood.
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Magnetic resonance imaging showed a mass that was hyperintense and moderately hyperintense on T1- and T2-weighted imaging, respectively, with and without fat suppression (Figure 5).
Resected specimen. The images show a 3 x 3.5 x 0.6 cm soft mass with no solid components. The content of the mass is a highly mucous, reddish brown fluid with no odor.
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Cystic fluid in the resected specimen was mucous and reddish brown, with no cellular components (Figure 6).
Histopathological examination. The wall of the mass is composed of two layers of smooth muscle fibers, and the cavity is lined with pseudostratified columnar epithelium. Bleeding and hemosiderin deposition are visible in certain areas of the cystic wall.
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Histopathological findings revealed that the cyst consisted of two layers of smooth muscle and the inside of the cavity was lined with pseudostratified columnar epithelium (Figure 7).