A pedunculated lymphangioma of the esophagus was unexpectedly discovered during an
endoscopic investigation performed for epigastric pain in a patient affected by diabetic
arteriopathy treated with antiplatelet drugs. The patient neither complained of dysphagia
nor other symptoms related to the presence of the lymphangioma which therefore can be
considered as an endoscopic “incidentaloma”.
The lesion was removed endoscopically and a follow up, 6 months later, showed no scar
or recurrence.
The authors present this case both for the extreme rarity of this lesion and for the
evidence of low-medium grade dysplasia in the overlying mucosa, particularly since it is
only case ever noted in literature.
This aspect suggests that, even if malignant degeneration of these lesions has never
been observed, their endoscopic removal is recommended. However, when endoscopic
procedures are not feasible, thoracotomic surgical exeresis should be only considered for
obstructing and symptomatic lesions; an accurate endoscopic and bioptic follow up can be
useful for asymptomatic lesions.