Endoscopic sclerotherapy for esophageal hemangioma

Endoscopic Band Ligation in Blue Rubber Bleb Nevus Syndrome: A Report of Two Children

Blue rubber bleb nevus syndrome (BRBNS) is a rare congenital disorder presenting with multifocal venous malformations of the skin, soft tissues, and gastrointestinal (GI) tract. Patients usually present with chronic anemia resulting from occult GI bleeding and sometimes with massive GI bleeding. We report 2 children with blue rubber bleb nevus syndrome with GI bleeding: 1 with obscure GI bleeding and the other with overt GI bleeding. In both cases, the presence of cutaneous lesions provided useful clues toward diagnosis. Colonoscopy and upper GI endoscopy revealed bluish polypoidal lesions in the GI tract. Capsule endoscopy helped in disease mapping. Both of them were successfully treated with endoscopic band ligation and nonselective beta-blockers, which resulted in an improvement in their hemoglobin levels. Our cases highlight the successful use of endoscopic band ligation of GI lesions as a therapeutic modality. It is important for gastroenterologists to be aware of this rare condition for current diagnosis.

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).

Beyond hepatic hemangiomas: the diverse appearances of gastrointestinal and genitourinary hemangiomas

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.

Successful en bloc resection of an esophageal hemangioma by combined EBL & EMR: a case report and technical review

A 58-year-old male was diagnosed esophageal hemangioma during a endoscopy in regular examination. The patient was referred to the department of gastroenterology in our hospital to treatment. Combined endoscopic band ligation (EBL) and endoscopic mucosal resection (EMR) was performed for diagnostic treatment. Histopathological results revealed hemangioma. Even though several approaches such as esophagectomy, endoscopic removal, sclerotherapy, and laser therapy have been used to remove the esophageal hemangiomas, recently less invasive methods were preferred. Here we describe a case of esophageal hemangioma removed by EBL & EMR.

Cervical esophageal hemangioma combined with thyroid cancer

Hemangiomas that arise in cervical esophagus are extremely rare, representing 3.3% of all benign esophageal tumors. Although endoscopic mucosal resection (EMR) and potassium titanyl phosphate/yttrium aluminum garnet (KTP/YAG) laser therapy have been used with success for small tumors, the safety and efficacy in the case of large tumors remains uncertain. We report the successful resection of cervical esophageal hemangioma through a cervical esophagotomy in a patient with thyroid cancer who needed a cervical collar incision.

Treatment of venous malformations with ethanolamine oleate: a descriptive study of 83 cases

PURPOSE

To evaluate the outcome and complications of sclerotherapy with injection ethanolamine oleate for the treatment of venous malformations (VMs).

METHODS

Eighty-three patients' (39 males and 44 females) age ranging from 3 months to 21 years with 85 lesions were followed clinically for about 1 year following treatment with injection of ethanolamine oleate. The cases were enrolled between January 2006 and December 2009. The amount of ethanolamine oleate per treatment session ranged from 0.50 to 10 ml, and maximum dose was 0.40 ml per kg body weight. All patients were evaluated after 8 weeks of last injection session. All of the treatment sessions were performed on a day-case basis.

RESULTS

Eighty-five lesions have under gone 201 sclerotherapy sessions with 39 requiring one, 27 requiring two and 19 lesions requiring more than two sessions. Sclerotherapy with ethanolamine oleate provided complete resolution of symptoms in 79 lesions and significant improvement of 6 lesions. There is no recurrence of studied patients. All patients experienced pain and swelling to a variable degree for short duration. Skin sloughed out in four patients which were healed spontaneously. No other complications were observed in our study.

CONCLUSION

The treatment of VMs with injection ethanolamine oleate is safe and effective.

A patient with esophageal hemangioma treated by endoscopic mucosal resection: a case report and review of the literature

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.

Treatment of benign esophageal tumors by endoscopic techniques

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.