Benign Esophageal Neoplasms

Benign Esophageal Neoplasms are rare, although probably many remain undetected. The most common lesions are mesenchymal tumors such as gastrointestinal stromal tumors and leiomyomas, followed by polyps. Less common lesions include hemangioma and granular cell myoblastoma.

A. Clinical features

Clinical features depend primarily on the location of the tumor within the esophagus. Intraluminal tumors, such as polyps, cause esophageal obstruction, and patients present with dysphagia, vomiting, and aspiration. Intramural tumors, such as leiomyomas, usually are asymptomatic, but if they are large enough, they can produce dysphagia or chest pain.

B. Diagnosis

Diagnosis usually involves a combination of barium swallow, esophagoscopy, and perhaps CT scanning or magnetic resonance (MR) scan studies.

C. Treatment

Treatment for all symptomatic or enlarging tumors is surgical removal. Intraluminal tumors can be removed successfully via endoscopy, but if they are large and vascular, they should be resected via thoracotomy and esophagostomy. Intramural tumors usually can be enucleated from the esophageal muscular wall without entering the mucosa. This is done via a video-assisted thoracoscopic or open thoracotomy approach. Laparoscopic resection may be appropriate for distal lesions.