Giant esophageal lipoma presenting with gastroesophageal reflux symptoms.
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ABSTRACT: Lipoma of the esophagus is rare. There are few reports of the endoscopic resection of esophageal lipoma. We present a 73-year-old woman with lipoma of the esophagus which was successfully extirpated using the technique of endoscopic mucosal resection. To determine the depth of tumor invasion, endoscopic ultrasonography was used. A total of 31 cases of esophageal lipoma have been reported in Japan. Of these, seven were successfully resected using endoscopic techniques. Lipomas of the esophagus can grow to become large pedunculated tumors which can obstruct the airway. The majority of these tumors occur in the cervical portion of the esophagus. Most patients have no symptoms. These tumors can be resected using minimally invasive surgery when they are small.Digestive Endoscopy 07/2008; 13(1):41 - 44. · 1.61 Impact Factor
- Gastrointestinal Endoscopy 06/2005; 61(6):756-9. · 4.90 Impact Factor
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ABSTRACT: Endoscopic treatment of a pedunculated submucosal tumor (SMT) has not been well established. In particular, endoscopic cautery snare resection of a large pedunculated SMT is discouraged because of the increased risk of bowel perforation. To report the clinical outcome of endoloop ligation for the treatment of various pedunculated SMTs with a clip-marking technique. Prospective evaluation of 10 patients who, between June 2005 and May 2006, received endoloop ligation with a clip-marking technique. At a tertiary-care, academic medical center. Ten patients with various pedunculated SMTs with either symptomatic lesions or large-sized lesions (>4 cm). Clinical procedural success, reported adverse events. Nine cases were successfully treated, with tumor removal within 4 weeks. In contrast, only 1 patient needed a second session of loop ligation. Only 6 specimens were retrieved. There were no procedure-related complications, such as bleeding or perforation. Retrieval by the patient of a specimen from stool was possible in only 60% of cases; a limited number of 10 patients; by oncology standards, not the correct treatment for nonlipomatous lesions, which limits its application to surgical risk candidates. Endoloop ligation of large pedunculated SMTs seemed to be technically feasible and appeared to be safe in this case series. Further controlled clinical trials have to be conducted before application of this technique to a large submucosal lipoma or other SMTs in surgical high-risk candidates can be generally recommended.Gastrointestinal Endoscopy 03/2008; 67(3):556-60. · 4.90 Impact Factor
J Gastrointestin Liver Dis, March 2013 Vol. 22 No 1: 8
Giant Esophageal Lipoma Presenting with Gastroesophageal
Suna Yapali1*, Nevin Oruc1, Mustafa Harman2, Ahmet Aydin1
1) Department of Gastroenterology; 2) Department of Radiology, Ege University, School of Medicine, Izmir, Turkey
A 65–year-old lady was admitted with a principal
complaint of heartburn. Upper GI endoscopy revealed an
intraluminal polypoid mass with a stalk occupying ¾ of the
esophageal lumen, originating at 20 cm from the incisors,
with its body extending downward to 30 cm, which measured
about 25 mm in its widest diameter (Fig. 1), associated with
grade B esophagitis . Esophagography showed a flling-
defect with luminal narrowing in the proximal esophagus.
Computed tomography (CT) scans demonstrated a central
fatty mass with a lower density tissue absorption surrounded
by a single ring of normal esophagus (Fig. 2). Endoscopic
ultrasonograpy (EUS) confrmed the submucosal origin of
the mass on the right proximal wall of the esophagus which
was homogeneously hyperechoic with regular margins, image
consistent with lipoma (Fig. 3).
Since she was reluctant to undergo any surgical or
endoscopic excision of the mass during the 3 year follow-
up period, dimensions of the mass lesion were stable and
symptoms of GERD were controlled on esomeprazole therapy.
As the pathophysiological relevance of esophageal lipoma and
GERD was not reported, this case may be assumed to be an
incidental giant esophageal lipoma with rare symptoms of
dysphagia. Although most of the reported cases are treated with
endoscopic and surgical approaches [2-6], the unique feature of
this case is an incidental giant esophageal lipoma presenting
with refux symptoms which remained asymptomatic during
follow-up. Long term follow-up is very important because of
the possibility of metachronous lesions or misdiagnosis of a
well diferentiated liposarcoma. It has been reported that the
tumor may grow 2.5 times over 3.75 years , though it is not
known exactly how long it takes for a lipoma to grow.
IMAGE OF THE ISSUE
Despite the fact that management depends on tumor size,
origin and presence of symptoms, larger tumors may also be
followed endoscopically and endosonograpically in the absence
of life-threatening symptoms.
*Corresponding author: firstname.lastname@example.org
Conficts of interest: None to declare.
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of the esophagus: report of a case. Digestive Endoscopy 2001;13: 41-
3. Janarthanan K, Shetty S, Mohanakrishnan A, Leelakrishnan. Esophageal
lipoma presenting as along tongue!! Indian J Gastroenterol 2011;30:
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loop assisted removal of large clinically signifcant colonic lipomas.
Gastrointest Endosc 2005;61: 756-759.
5. Lee SH, Park JH, Park do H, et al. Endoloop ligation of large
pedunculated submucosal tumors. Gastrointest Endosc 2008;67: 556-
6. Algin C, Hacioglu A, Aydin T, Ihtiyar E. Esophagectomy in esophageal
lipoma: report of a case. Turk J Gastroenterol 2006;17: 110-112.
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