A patient with esophageal hemangioma treated by endoscopic mucosal resection: a case report and review of the literature

Abstract

In a 58-year-old male, upper digestive endoscopy revealed a protruding lesion in the esophagus on a medical examination. The patient was referred to the Department of Surgery in our hospital to undergo surgery. On the initial consultation, upper digestive endoscopy showed a smooth, soft, black purple, type II protruding lesion measuring approximately 25 mm at 35 cm apart from the incisor. For diagnostic treatment and patient's request, endoscopic mucosal resection (EMR) was performed. The resected specimen measured 25 mm x 25 mm. The histological findings suggested cavernous hemangioma. To treat esophageal hemangioma, esohagectomy, tumor enucleation, or sclerotherapy has been performed. However, recently, thorough preoperative examination, such as endoscopic ultrasonography (EUS), has facilitated endoscopic resection, such as EMR.

Successful en bloc resection of an esophageal hemangioma by endoscopic submucosal dissection

“…conventional surgical approach to treatment, but recently less invasive approaches by endoscopic therapy have become more widely used [2,3]. However, because conventional endoscopic therapy cannot obtain specimens for pathological examination and is associated with a risk of residual or recurrent hemangioma [4], en bloc removal is another possible treatment option.…”

Successful en bloc resection of an esophageal hemangioma by combined EBL & EMR: a case report and technical review

“…Less invasive approaches by endoscopic therapy have become more widely used recently (2,3). Because, conventional endoscopic therapy cannot obtain specimens for pathological examination and is associated with a risk residual or recurrent hemangioma (11).…”

“…Esophagectomy is the conventional surgical approach to treatment, but recently less invasive approaches by endoscopic mucosal resection (EMR) have become more widely used (2,3). EMR of esophageal hemangioma is rare.…”

Beyond hepatic hemangiomas: the diverse appearances of gastrointestinal and genitourinary hemangiomas

“…On EUS, hemangiomas are submucosal lesions with heterogeneous echogenicity. They may appear anechoic, hypoechoic, or isoechoic to the adjacent layers of muscle [47,53]. Tortuous vessels and echogenic, shadowing phleboliths may be present [47] (Online Resource 2).…”

“…Enucleation is commonly used in the treatment of entirely submucosal lesions [54]. Endoscopic mucosal resection has also been described [53] and is advised for lesions less than 2.5 cm [49]. Endoscopic polypectomy may be preferred for small, pedunculated hemangiomas [50,55].…”