Intramural esophageal tumors

Abstract

IntroductionIntramural esophageal tumors (IET) are located between unchanged mucous membrane and muscularis mucosae. They can be both benign and malignant.AimTo evaluate diagnostic and therapeutic difficulties of IET.Material and methodsDuring the years 2010–2015, 11 patients with IET were treated in our clinic. Diagnostics included gastroscopy, computed tomography of the chest, endoscopic ultrasound (EUS) guided fine needle biopsy, and positron emission tomography (PET) of the esophagus in cases with no histopathological confirmation.ResultsBased on the conducted analysis we diagnosed 1 case of gastrointestinal stromal tumor (GIST), 1 case of adenocarcinoma, and 2 cases of esophageal cysts. In another 7 cases radiological images resembled leiomyoma but with no histopathological confirmation. Esophagectomy was performed in 2 cases of malignant tumors and 1 case of a large benign tumor. In other cases surgical enucleation of tumors was performed. Postoperatively we diagnosed 6 cases of leiomyoma, 1 case of schwannoma, 2 esophageal cysts, 1 case of GIST and 1 of esophageal cancer.ConclusionsIntramural esophageal tumors is a very diverse group of tumors, both malignant and benign. In every case of IET we should seek histopathological conformation. Treatment of IET depends on localization, size and histopathological type of lesion.

Robotic enucleation for oesophageal benign and borderline tumours: Less is more?

“…Oesophageal non‐epithelial benign to borderline tumours are rare entities with a reported incidence of <1% among all oesophageal tumours 1,2 . The rarity of these lesions result in a lack of clear recommendation of their management, and the surgical treatment remains unclear.…”

“…Surgical complete resection is the mainstay of therapy for fit‐for‐surgery patients with a suspected or established malignant lesion. Due to the anatomical position of the oesophagus, the surgical options are limited to the oesophagectomy or the tumour enucleation 1,4 . The guidelines for the timing to perform each procedure are controversial.…”

“…However, their global incidence accounts for less than 1% of oesophageal tumours, and arise from vessels, nerves, smooth muscles and mucous glands of the oesophagus. The most common presenting symptom is mild to moderate dysphagia 1,2 . Although most of these have a benign or indolent behaviour (leiomyoma, lipoma, cyst), the possibility of malignancies exists (leiomyosarcoma and gastrointestinal stromal tumour [GIST]).…”