Extended hemangioma from pharynx to esophagus that could be misdiagnosed as an esophageal varix on endoscopy

Abstract

Giant hemangioma in the neck and head is an uncommon vascular neoplasm and has an unpredictable clinical behavior. We report a hemangioma that extended from the pharynx to the esophagus that could have been misdiagnosed as an esophageal varix. A 42-year-old man with dilated varices-like vessels on his esophagus that were incidentally detected by endoscopy was referred to our hospital for further evaluation. On re-examined endoscopy, multiple vascular dilatations were noted in the pharynx, expanding into the esophagogastric junction. These dilatations looked like esophageal varices that are found in patients with liver cirrhosis. There was no significant abnormality, including liver cirrhosis, on the abdomino-pelvic computed tomography scan. On the endoscopic esophageal biopsy, dilatedsubmucosal blood vessels were diagnosed as hemangioma. In consultation with an otorhinolaryngologist for evaluation of the risk of hemangioma, it was determined that the hemangioma was not dangerous to the patient as long as it did not cause hoarseness, dyspnea or dysphagia. We planned regular 6-month follow ups. We report a case of extended hemangioma that could possibly have been misdiagnosed as an esophageal varix on endoscopy. Even if head and neck hemangioma is uncommon, careful consideration during endoscopy is required to avoid the misdiagnosis of varices or hemangioma.

Bluish discoloration of the esophagus: cavernous hemangioma of the pharynx and larynx with esophageal involvement

“…Esophagectomy or tumor enucleation has been used to treat esophageal hemangioma. Recently, endoscopic sclerotherapy, laser therapy, and endoscopic mucosal resection have also been reported [3]. In the present case, the patient will undergo a partial resection.…”

Unusual presentation of an adult pedunculated hemangioma of the oropharynx

“…Pharyngeal hemangiomas are extremely rare, particularly in the oropharynx [9]. Including this case, the team also reviewed 12 cases of pharynx hemangioma in the literature published in English [7][8][9][10][11][12][13][14][15][16][17] (Table 1). Of these 12 cases, 10 were located in hypopharynx with various extensions, only one was in oropharynx, and one was unspecified.…”

“…It seems that 60% appear in the head and neck (i.e., skin, subcutaneous tissues, tongue, nasal mucosa, oral cavity, larynx, and salivary glands) [5,6] even if hemangiomas occurring in the pharynx are uncommon [7]. Close observation can be sufficient, in the case of silent hemangioma, while functional compromise requires aggressive treatment [8]. In this study, an unusual case of a mixed oropharyngeal pedunculated hemangioma inserted into the base of tongue in a young female is described.…”

Surgical Treatment of Laryngeal Haemangioma Laser CO2 Excision: Our Experience in Adult Patients

“…10 Potential complications consist of growth along with alteration of the laryngeal functionality; in the most advanced cases, it might even give rise to obstructive symptoms of the respiratory tracts and to hemorrhage. 11 We should bear in mind that it is not a progressive tumor, hence in some instances clinical observation is the preferable treatment; 12 given, however, the risk of hemorrhage, an aggressive type of treatment is instead opted for. 5 The therapeutic options envisage endoscopic removal with CO 2 laser, use of systemic steroids, interferon, and intralesional corticosteroid injections with short-term intubation.…”