Symptomatic esophageal hemangioma removed by EMR

Endoscopic Submucosal Dissection: A Safe and Effective Alternative to Surgical Intervention for Esophageal Hemangioma

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.

Successful en bloc resection of large esophageal hemangioma by endoscopic submucosal dissection: A case report

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).