Large Pedunculated Lipoma of the Esophagus

Abstract

Pedunculated lipoma of the esophagus is rare and easily misdiagnosed in clinical practice. The presenting symptoms of esophageal lipoma are dysphagia, regurgitated mass and persistent sensation of a lump in the throat. The most frequent location of the tumor pedicle is the upper esophageal sphincter. Although the lipoma is pathologically benign, if it is large enough, it may cause airway obstruction secondary to the mechanical pressure to the larynx when the tumor is regurgitated. We present the case of a 67-year-old man who had the symptoms of dysphagia, nausea and vomiting. Esophagography and chest computed tomography revealed that he might have an esophageal submucosal or intraluminal tumor mass. Panendoscopy showed a pedunculated tumor mass within the esophageal lumen with its peduncle arising from the cervical esophagus. The tumor mass measured 9.0 x 4.7 x 2.5 cm in size. Thoracic approach via the right chest wall was performed for confirmation. After removal of the intraluminal mass, the patients symptoms dramatically improved. Pathology showed a lipoma arising from the submucosa of the esophagus.

Giant pedunclated lipoma of the esophagus: A case report

“…In general, esophageal lipoma commonly has a predilection [6]. The choice of intervention, which is either endoscopic or surgical approaches, does not depend on only tumor size or location of the mass, but also the presence of the stalk.…”

Gigantinės stemplės lipomos komplikuotas chirurginis gydymas: klinikinis atvejis

“…Surgical excision is recommended for symptomatic benign tumours and those greater than 5 cm [3]. Although the pulmonary complications associated with open surgery can be avoided by an endoscopic approach, open surgical approach provides operators with a better visual operating field, enables better control for managing large tumours and prevent bleeding caused by endoscopic transection of the vessel-enriched pedicle [14]. In our case, the tumour was large, exceeding 13 cm, the length and diameter of the pedicle were unclear before surgery.…”

More than just a tickle in the throat, a giant oesophageal lipoma

“…Both endoscopic and surgical approaches are well described in the literature for excision of these benign lesions 9 . Endoscopic approaches are reported to achieve adequate resection in smaller lesions, in comparison to a surgical approach, with lower risks of morbidity such as wound tenderness or pulmonary complications.…”

“…Endoscopic approaches are reported to achieve adequate resection in smaller lesions, in comparison to a surgical approach, with lower risks of morbidity such as wound tenderness or pulmonary complications. However, open surgical resection is proven to reduce the risk of incomplete excision, bleeding, and perforation, all of which has been previously described in endoscopic excisions 9,10 . Multiple surgical approaches have been defined for removal of benign oesophageal lesions: the most common being cervicotomy, followed by endoscopic resection via thoracotomy or even by performing an oesophagectomy 10 .…”

“…8 Both endoscopic and surgical approaches are well described in the literature for excision of these benign lesions. 9 Endoscopic approaches are reported to achieve adequate resection in smaller lesions, in comparison to a surgical approach, with lower risks of morbidity such as wound tenderness or pulmonary complications. However, open surgical resection is proven to reduce the risk of incomplete excision, bleeding, and perforation, all of which has been previously described in endoscopic excisions.…”