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Zhongsheng L, Yan D, Ezzat R, Chen M, Jing Y, El-Kassas M, Tawheed A, Madkour A. Endoscopic Submucosal Dissection: A Safe and Effective Alternative to Surgical Intervention for Esophageal Hemangioma. Surg Laparosc Endosc Percutan Tech 2024; 34:124-128. [PMID: 38372527 DOI: 10.1097/sle.0000000000001266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/24/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Hemangiomas represent 3% of all benign esophageal tumors. Conventional esophagectomy is the standard treatment with its invasive nature and possible surgical complications. Now, less invasive techniques are used with better results. Endoscopic submucosal dissection (ESD) is one of the novel noninvasive methods used for en bloc removal of tumors. No available data about the use of ESD in removing esophageal hemangioma. Here, we studied the validity and safety of ESD as a minimally invasive procedure to remove esophageal hemangioma. METHODS Three patients were diagnosed with esophageal hemangioma and underwent ESD with en bloc resection. Endoscopic ultrasound (EUS) was performed before ESD to better evaluate the layer of origin and vascularity and guard against perforation. Patients were followed up postintervention to document possible complications. RESULTS Among the 3 studied patients, one presented with chronic abdominal pain, the second was complaining of dysphagia, and the third patient was diagnosed accidentally. Pathology reports confirmed the diagnosis of hemangiomas in all cases with no atypia and complete removal of the lesions. No complications were reported during the procedure or over the follow-up period. CONCLUSIONS ESD is a proper, minimally invasive method with good en bloc resection that can be used in cases of esophageal hemangiomas.
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Affiliation(s)
| | - Dou Yan
- Departments of Gastroenterology
| | - Reem Ezzat
- Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut
| | - Mu Chen
- Pathology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yuan Jing
- Pathology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Ahmed Tawheed
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Ahmad Madkour
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
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Yu Y, Shen B, Zhang C, Zhang J, Cao L, Lu P, Liu M. Successful en bloc resection of large esophageal hemangioma by endoscopic submucosal dissection: A case report. Medicine (Baltimore) 2020; 99:e22821. [PMID: 33120807 PMCID: PMC7581152 DOI: 10.1097/md.0000000000022821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONALE With the development of endoscopic techniques, endoscopic therapy began to play an important role in the management of esophageal hemangiomas. PATIENTS CONCERNS A large esophageal submucosal tumor (2.5 cm), which was suspected to be an esophageal hemangioma, was diagnosed in a 50-year-old woman. DIAGNOSIS Esophageal hemangioma INTERVENTIONS:: Endoscopic submucosal dissection was performed for tumor removal. OUTCOMES Histopathological results revealed hemangioma. No complication or recurrence was observed in the 17-month follow-up period. LESSONS Our successful experience showed that endoscopic submucosal dissection is an effective and a safe approach to treat large esophageal hemangiomas (2.5 cm).
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Affiliation(s)
- Yan Yu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Bingzheng Shen
- Department of Pharmacy, Renmin Hospital of Wuhan University
| | - Chao Zhang
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Jiqiao Zhang
- Department of Gastroenterology, Minda Hospital of Hubei Minzu University, Enshi City, China
| | - Li Cao
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Panpan Lu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Mei Liu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
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3
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Kumar N, Adam SZ, Goodhartz LA, Hoff FL, Lo AA, Miller FH. Beyond hepatic hemangiomas: the diverse appearances of gastrointestinal and genitourinary hemangiomas. ACTA ACUST UNITED AC 2016; 40:3313-29. [PMID: 26239397 DOI: 10.1007/s00261-015-0515-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hemangiomas are common lesions, best known for their appearance in the liver. Their appearance in less common locations, such as the gastrointestinal and genitourinary tracts, is less well known. We will review the typical and atypical appearance of hemangiomas in these locations on sonography, CT, and MRI.
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Affiliation(s)
- Nishant Kumar
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA
| | - Sharon Z Adam
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA
| | - Lori A Goodhartz
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA
| | - Frederick L Hoff
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA
| | - Amy A Lo
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Frank H Miller
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA.
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Kim JH, Jung SW, Song JG, Choe JW, Kim SY, Hyun JJ, Jung YK, Koo JS, Yim HJ, Lee SW. [Esophageal Hemangioma Treated by Endoscopic Mucosal Resection: A Case Report and Review of the Literature]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2015; 66:277-81. [PMID: 26586351 DOI: 10.4166/kjg.2015.66.5.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hemangioma of the esophagus is a rare form of benign esophageal tumor. It usually presents as a single lesion located in the lower third of the esophagus and is mostly asymptomatic. However, it may occasionally cause hematemesis and/or obstruction. Surgical resection is the conventional treatment modality for managing esophageal hemangioma, but less invasive approaches such as endoscopic therapy are recently becoming more widely employed. Herein, we report a case of a 54-year-old man who presented with an esophageal hemangioma that was successfully treated by endoscopic mucosal resection without any complications.
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Affiliation(s)
- Ji Hye Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Gyu Song
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jung Wan Choe
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seoung Young Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Jin Hyun
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kul Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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5
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Abstract
Benign esophageal and paraesophageal masses and cysts are a rare but important group of pathologies. Although often asymptomatic, these lesions can cause a variety of symptoms and, in some cases, demonstrate variable biological behavior. Contemporary categorization relies heavily on endoscopic ultrasound and other imaging modalities and immunohistochemical analysis when appropriate. Minimally invasive options including endoscopic, laparoscopic, and thoracoscopic methods are increasingly used for symptomatic or indeterminate lesions.
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Affiliation(s)
- Cindy Ha
- Department of Surgery, Division of General Surgery at SIU, Southern Illinois University School of Medicine, 701 North First Street, Springfield, IL 62794, USA
| | - James Regan
- Department of Surgery, Division of General Surgery at SIU, Southern Illinois University School of Medicine, 701 North First Street, Springfield, IL 62794, USA
| | - Ibrahim Bulent Cetindag
- Department of Surgery, Division of General Surgery at SIU, Southern Illinois University School of Medicine, 701 North First Street, Springfield, IL 62794, USA
| | - Aman Ali
- Department of Internal Medicine, Division of Gastroenterology, Southern Illinois University School of Medicine, 701 North First Street, Springfield, IL 62794, USA
| | - John D Mellinger
- Department of Surgery, Division of General Surgery at SIU, Southern Illinois University School of Medicine, 701 North First Street, Springfield, IL 62794, USA.
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6
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Liu WW, Xiao F, Yu LZ, Lin L, Shi RH, Yang SP. Clinical characteristics and treatment of esophageal hemangioma: Analysis of 48 cases. Shijie Huaren Xiaohua Zazhi 2014; 22:3464. [DOI: 10.11569/wcjd.v22.i23.3464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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8
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Heitmiller RF, Brock MV. Benign Tumors and Cysts of the Esophagus. SHACKELFORD'S SURGERY OF THE ALIMENTARY TRACT 2013:462-477. [DOI: 10.1016/b978-1-4377-2206-2.00038-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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9
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Elmunzer BJ, Piraka C. Symptomatic esophageal hemangioma removed by EMR. Gastrointest Endosc 2008; 67:173-4. [PMID: 17945230 DOI: 10.1016/j.gie.2007.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2007] [Accepted: 04/30/2007] [Indexed: 01/02/2023]
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10
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Sogabe M, Taniki T, Fukui Y, Yoshida T, Okamoto K, Okita Y, Hayashi H, Kimuara E, Kimura Y, Onose Y, Ozaki Y, Iwaki H, Sato K, Hibino S, Sawada S, Muguruma N, Okamura S, Ito S. A patient with esophageal hemangioma treated by endoscopic mucosal resection: a case report and review of the literature. THE JOURNAL OF MEDICAL INVESTIGATION 2006; 53:177-182. [PMID: 16538013 DOI: 10.2152/jmi.53.177] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In a 58-year-old male, upper digestive endoscopy revealed a protruding lesion in the esophagus on a medical examination. The patient was referred to the Department of Surgery in our hospital to undergo surgery. On the initial consultation, upper digestive endoscopy showed a smooth, soft, black purple, type II protruding lesion measuring approximately 25 mm at 35 cm apart from the incisor. For diagnostic treatment and patient's request, endoscopic mucosal resection (EMR) was performed. The resected specimen measured 25 mm x 25 mm. The histological findings suggested cavernous hemangioma. To treat esophageal hemangioma, esohagectomy, tumor enucleation, or sclerotherapy has been performed. However, recently, thorough preoperative examination, such as endoscopic ultrasonography (EUS), has facilitated endoscopic resection, such as EMR.
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Affiliation(s)
- Masahiro Sogabe
- Department of Digestive and Cardiovascular Medicine, The University of Tokushima Graduate School, Japan
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Abstract
Gastrointestinal endoscopy has changed in recent years from a largely diagnostic to a highly therapeutic procedure. Technical advances in endoscopic ultrasound as well as new devices designed for endoscopic mucosal resection (EMR) have opened the field to many therapeutic possibilities. Endoscopic resection is technically challenging, and while our colleagues in the Far East have been using such techniques for over a decade, EMR in the West is still in its infancy. The decision to resect a benign esophageal tumor must take several factors into account including whether the patient is symptomatic; characteristics of the particular tumor (including the potential for malignant transformation, risk of bleeding, and obstruction); and the available therapeutic options. Endoscopic resection of benign esophageal tumors is an attractive option as it is a safe and minimally invasive procedure. Its use is limited, however, to smaller tumors arising from the mucosal or submucosal layers. In this article we examine the techniques used in endoscopic mucosal resection and review the literature on this subject.
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Affiliation(s)
- Timothy Kinney
- Section of Endoscopy and Therapeutics, University of Chicago, Chicago, IL 60637, USA
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12
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Samphire J, Nafteux P, Luketich J. Minimally invasive techniques for resection of benign esophageal tumors. Semin Thorac Cardiovasc Surg 2003; 15:35-43. [PMID: 12813687 DOI: 10.1016/s1043-0679(03)00005-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
With the emergence of minimally invasive surgery (MIS), laparoscopy and thoracoscopy have become feasible and safe alternatives to open surgical procedures in the management of esophageal leiomyomas. The indications for MIS resection of leiomyomas at our institution include the presence of symptoms, confirmation of pathology to exclude malignancy, tumors greater than 2 cm in size or tumors that show evidence of growth. Our approach of choice is right video-assisted thoracoscopic surgery (VATS) for tumors of the thoracic esophagus and laparoscopy for tumors of the intra-abdominal esophagus or gastroesophageal junction. A detailed description of these surgical approaches is outlined in the following chapter. At our institution, nine patients, 8 males and 2 females with a mean age of 54 years (range 42-67 years) had a minimally invasive surgical resection of an esophageal leiomyoma between 1995 and 2001. The surgical approaches included right VATS enucleation (6) and laparoscopic enucleation (3). There were no major morbidities, including postoperative leaks or mortalities. The mean hospital stay was 2.3 days. All tumors were benign leiomyomas with average size of 2.73 cm (range 0.9-8 cm) and there was no evidence of recurrence at a mean follow-up of 10 months. Video-assisted enucleation has shown in our institution, as well as in others, that the procedure can be performed safely with low mortality and morbidity. A VATS or laparoscopic approach to the removal of leiomyomas should be the treatment of choice in centers experienced in minimally invasive surgery.
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Affiliation(s)
- John Samphire
- Division of Thoracic and Foregut Surgery, UPMC Presbyterian, Pittsburgh, PA 15213, USA
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13
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Abstract
Esophageal hemangioma is a rare tumor. This report describes the case of a 69-year-old woman with an esophageal tumor at the middle portion of the esophagus. The patient was successfully treated with minimal access thoracic surgery, and at the 6 month follow-up, the patient was free of any symptoms or recurrence.
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Affiliation(s)
- Y C Wu
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
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14
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Shigemitsu K, Naomoto Y, Yamatsuji T, Ono K, Aoki H, Haisa M, Tanaka N. Esophageal hemangioma successfully treated by fulguration using potassium titanyl phosphate/yttrium aluminum garnet (KTP/YAG) laser: a case report. Dis Esophagus 2000; 13:161-4. [PMID: 14601909 DOI: 10.1046/j.1442-2050.2000.00087.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal hemangioma is an extremely rare tumor. We report a case of a 39-year-old man who was found to have an hemangioma which extended from the hypopharynx to the upper thoracic esophagus revealed by endoscopic examination. Computed tomography (CT) images, magnetic resonance imaging (MRI) and angiography were useful in the diagnosis. He was successfully treated by fulguration using potassium titanyl phosphate/yttrium aluminum garnet (KTP/YAG laser) four times and no recurrence has been seen. This patient has since been followed up carefully and additional fulguration will be performed if necessary. KTP/YAG laser is useful for the treatment of a large hemangioma as a less invasive method.
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Affiliation(s)
- K Shigemitsu
- The First Department of Surgery, Medical school, Faculty of Medicine, Okayama University, 2-5-1 Shikata-cho, Okayama City, Okayama Prefecture, Japan
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