Endoscopic submucosal dissection for a rare cause of esophageal mass: Von Recklinghausen's neurofibromatosis

A 72-year-old woman was admitted to our hospital with a 20-year history of intermittent subxiphoid pain, which intensified in the past 2 months. Physical examination revealed dermal manifestations suggestive of neurofibromatosis ([Fig. 1]a). Enhanced computed tomography identified thickening of the distal esophageal wall. During upper endoscopy, a mass was observed stretching from the lower esophagus to the gastric cardia, leading to partial esophageal obstruction ([Fig. 1]b). Endoscopic ultrasound depicted a hypoechoic submucosal mass, distinguished by several anechoic lesions extending into the esophageal lumen ([Fig. 1]c). With informed consent from the patient, the mass was successfully excised using endoscopic submucosal dissection ([Fig. 1]d, [Video 1]). The extracted specimen measured 3.0 × 5.0 × 5.0 cm ([Fig. 1]e). Histopathological evaluation confirmed neurofibromatosis, identified by neurofibromatous cells encircling the specimen ([Fig. 1]f). The patient experienced no symptoms and showed no signs of recurrence or residual mass on follow-up endoscopic evaluations over 1 year.