Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2024; 16(2): 543-549
Published online Feb 15, 2024. doi: 10.4251/wjgo.v16.i2.543
Large isolated fibrous tumors in the upper esophagus: A case report
Jia-Jia Yu, Huan-Shuang Pei, Yu Meng
Jia-Jia Yu, Huan-Shuang Pei, Yu Meng, Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Author contributions: Yu JJ and Meng Y participated in anesthesia management in the present case, and both were major contributors to this manuscript; Pei HS helped revise the manuscript; all the authors have read and approved the final version of the manuscript.
Informed consent statement: The patient profiled in this case report provided written informed consent for the anonymized publication of his case report findings and all accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Huan-Shuang Pei, MD, Associate Professor, Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, No. 12 Jian-Kang Road, Chang’an District, Shijiazhuang 050000, Hebei Province, China. wxhmz99999@163.com
Received: September 24, 2023
Peer-review started: September 24, 2023
First decision: December 12, 2023
Revised: December 13, 2023
Accepted: January 11, 2024
Article in press: January 11, 2024
Published online: February 15, 2024
Abstract
BACKGROUND

Solitary fibrous tumors (SFT) are rare spindle cell tumors that are usually benign. A total of 10 cases of SFTs in the upper esophagus have ever been reported. Here, we report the anesthetic management of a patient with a large isolated fibrous tumor of the upper esophagus compressing the tracheal membrane. We also provide a literature review of the current research.

CASE SUMMARY

We report the case of a 49 year old male with “cough aggravation and wheezing after exercise”, who underwent esophagectomy for a large isolated fibrous tumor compressing the tracheal membrane in the upper esophagus. We advise the use of a single-lumen tube with a blocker in patients with difficult airways to reduce the incidence of airway injury and fibrinoscopy at all stages of the perioperative period to guide airway management. This case study is the first report of the anesthetic management of a large, isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.

CONCLUSION

This rare case emphasizes the importance of perioperative management of anesthesia in patients with large isolated fibrous tumors of the upper esophagus that compress the tracheal membrane. The use of blocker reduce the incidence of airway injury and fibrinoscopy at the perioperative period to guide airway management.

Keywords: Upper esophagus, Isolated fibrous tumor, Tracheal membrane, Peak airway pressure, Case report

Core Tip: Tracheobronchial injury is rare, but the mortality rate is high. A patient with large isolated fibrous tumor in the upper esophagus are at a high risk of airway injury during surgery due to the compression of the tracheal membrane, poor airway expandability. Our management experience shows that airway tools are preferred to single-lumen tubes with blockers for patients with difficult airways, which reduces the incidence of airway injury. Perioperative application of fibrinoscopy is necessary to monitor airway safety in real time and close cooperation with the operator reduces airway injury.