Giant myxofibrosarcoma of the esophagus treated by endoscopic submucosal dissection: A case report

BACKGROUND: Myxofibrosarcoma (MFS) is a fibroblast-derived sarcoma that mainly occurs in subcutaneous tissue. MFS rarely occurs in the gastrointestinal tract, especially in the esophagus. CASE SUMMARY: A 79-year-old male patient was admitted to our hospital for dysphagia for a week. Computed tomography and electronic gastroscopy showed that a giant mass was located 30 cm from the incisor and extended to the cardia. There was incomplete esophageal stenosis. Endoscopic pathology showed spindle cell lesions, which were considered inflammatory myofibroblast like hyperplasia. Considering the strong demands of the patient and his family, and the fact that most inflammatory myofibroblast tumors are benign, we decided to perform endoscopic submucosal dissection (ESD) even if the tumor size was giant (9.0 cm × 3.0 cm). Postoperative pathological examination resulted in a final diagnosis of MFS. MFS rarely occurs in the gastrointestinal tract, especially in the esophagus. Surgical resection and local adjuvant radiotherapy are the first choices to improve the prognosis. This case report firstly described the ESD for esophageal giant MFS. It suggests that ESD may be an alternative treatment for primary esophageal MFS. CONCLUSION: This case report for the first time describe the successful treatment of a giant esophageal MFS by ESD, suggesting that ESD may be an alternative treatment for primary esophageal MFS, especially in elderly high-risk patients with obvious dysphagia symptoms.