Peripheral nerve sheath tumors of the esophagus originate from the peripheral nerves in the esophageal plexus. They are extremely rare, slow growing, and cause progressive symptoms; schwannomas are the most common form. Histological studies and immunohistochemistry are required to diagnose and differentiate them from other tumors, including gastrointestinal stromal tumors, and as they are resistant to chemotherapy and radiotherapy, surgical resection is the treatment of choice.
We present a case of a man presenting with asymptomatic tumor in the posterior mediastinum that was discovered incidentally on a chest X-ray. The tumor was resected en bloc (esophagectomy), and as malignancy was not confirmed, reconstruction was deferred to a later date (gastric pull-up). The pathology analysis eventually confirmed it was a benign schwannoma that was immunohistochemically positive for S-100 and Ki-67.