The value of endoscopic ultrasonography on diagnosis and treatment of esophageal hamartoma

Xu, Guofan; Hu, Fengling; Chen, Lihua; Guo, Siyu; Zhang, Bing-Ling

doi:10.1631/jzus.b0820049

Cited by 7 publications

(9 citation statements)

References 11 publications

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“…In our case EUS was not usable because of very proximal location of the tumour in the oesophagus but CT scan revealed cystic nature of the tumour and the tumour appeared benign in nature. In contrast to our finding Zhang et al have reported usefulness of EUS in the differential diagnosis of cervical oesophageal hamartomas (8).There are a few reports on successful endoscopic treatments of oesophageal hamartomas (5,16,17). According to Ginai et al a prerequisite for successful endoscopic ligation of the hamartoma is that it is pediculated (15).…”

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confidence: 94%

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A hamartoma presenting as an intramural upper oesophageal tumour

et al. 2017

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Oesophageal hamartomas are extremely rare conditions especially in upper oesophagus. We report on a 20-year-old woman who presented with dysphagia and was diagnosed with a retrosternal 4.9 cm × 9.0 cm heterogenic tumour located in her upper oesophagus. Preoperative examinations included computed tomography of the chest, bronchoscopy and esophagoscopy, and no signs of malignancy were noted. She underwent surgical resection of the mass and the final histopathological diagnosis was osteochondromatous hamartoma of the upper oesophagus. No acute or long-term complications or tumour recurrence were noted during a 6-year follow-up. Operative treatment was scheduled, but due to patientrelated factors, the operation was postponed to September 2010. Operative treatment consisted of a neck incision to approach the oesophagus, which was then encircled and muscular wall was opened vertically keeping the mucosa intact. The tumour was identified between muscle and mucosal layer and a pericapsular enucleation was performed (Figure 2). The patient was discharged on the second postoperative day without any primary complications. On a follow-up visit one month later the patient complained hoarseness and a consultation was appointed at the Department of Otolaryngology-Head and Neck Surgery. Left vocal cord paralysis was noted and scheduled for follow-up. During the first 1-year follow-up, her hoarseness subsided without any intervention and the patient has remained also otherwise symptomless. Pathologic findingsIn light microscopy the surgical specimen composed of mature fat tissue, fibrous tissue, cartilage and benign glandular structures (Figure 3). DiscussionWe report on a rare finding of a mediastinal mass that was diagnosed as a large intramural hamartomatous tumour of the proximal oesophagus. The final diagnosis was only evident macroscopically perioperatively and histopathologically after surgical resection of the entire tumour mass. This report adds to the differential diagnosis of slowly growing upper mediastinal tumours. More importantly it demonstrates the importance of preoperative assessment and the value of preparing the patient even for major resections and reconstructions even though the final surgical outcome based on a rare histological alternative may lead to a totally different outcome.Benign tumours of the oesophagus are rare accounting up to 0.5% or less of all oesophageal tumours at autopsy (11,12). Other types of tumours rise from distal to middle oesophagus, and only fibrovascular polyps tend to dominate in upper oesophagus (12). The most common tumour type is leiomyoma, while other benign tumours are rare, such as neurofibromas (schwannoma), granular cell tumours, hemangiomas, lipomas, and other types of polyps like hamartoma (13). Previous reports have described intraluminal polypomatous descriptions of oesophageal hamartoma or lower intramural oesophageal hamartoma (2,3,5,14) or lower intramural oesophageal hamartoma (4). Hamartoma in cervical oesophagus of adults is extremely rare and only fi...

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contrasting

confidence: 94%

“…There are a few reports on successful endoscopic treatments of oesophageal hamartomas (5,16,17). According to Ginai et al a prerequisite for successful endoscopic ligation of the hamartoma is that it is pediculated (15).…”

Section: A B C a Bmentioning

confidence: 99%

A hamartoma presenting as an intramural upper oesophageal tumour

et al. 2017

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“…To the best of our knowledge, twenty studies with twenty esophageal hamartoma cases (1,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) have been reported and eight of these studies described (4,6,8,10,11) were cervical or upper esophagus hamartomas [Halfhide et al (10) and Ginai et al (11) reported the same case], and five cases (5,7,9,13) were in distal or lower esophagus [one (9) was in Chinese, Table 1]. Several other studies (23-32) also reported congenital esophageal stenosis caused by tracheobronchial remnants.…”

Section: Discussionmentioning

confidence: 99%

“…In this case, the clinical manifestation and auxiliary examination were not specific, and EUS-FNA played an important role in preoperative diagnosis of the hamartoma. Xu et al (19) reported that EUS was superior to other imaging techniques, including barium esophagogram, contrast-enhanced CT image and conventional gastroscopy, in the diagnosis and treatment of hamartoma. Indeed, EUS can provide helpful diagnostic accuracy and comprehensive pre-operative assessment of submucosal tumors of the esophagus, including more detailed information about the tumor size, layer of origin, morphologic features, and even histopathological components (35).…”

Section: Discussionmentioning

confidence: 99%

“…Most of the previously reported patients underwent surgical treatment, including esophagectomy and thoracotomy, while one underwent endoscopic resection by snare coagulation (10), two underwent routine endoscopic resection (19,20) and one refused operation (1). Ginai et al (11) suggested that the resection method depends on the polyp's volume and site of origin.…”

Section: Discussionmentioning

confidence: 99%

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Chondromatous hamartoma of cervical esophagus: a case report and literature review

Zhang

Wang

et al. 2017

J. Thorac. Dis.

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Esophageal chondromatous hamartomas are very rare tumors, characterized by proliferating hyaline cartilage cells. We described the case of a 64-year-old woman, with a progressive foreign body sensation in the laryngopharynx caused by an intraluminal pedicled mass. Transcervical esophagectomy was performed and intraoperative biopsy revealed the mass was a cervical esophageal chondromatous hamartoma.The patient's postoperative course was uneventful and she recovered well. A review of the literature was conducted, and the symptoms, locations, histopathology findings, treatment methods and follow up results of esophageal hamartoma cases were summarized. We found that pre-operative endoscopic ultrasonographyguided fine-needle aspiration (EUS-FNA) can aid in diagnosis and that aggressive surgical treatment should be recommended for cervical esophageal hamartomas.

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