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  You are here : > Health Centers > Cancer Health Center > Esophageal cancer > Benign Esophageal Tumors

Benign Esophageal Tumors

Esophageal Cancer

Benign Esophageal Tumors

Benign Esophageal Tumors

  • Benign esophageal tumors
  • General Considerations
  • Clinical Findings
  • L Symptoms and Signs
  • L Imaging
  • Treatment

  • References
  • - James C. Chou, MD & Frank G. Gress, MD

    Benign Esophageal Tumors

    A variety of benign mass lesions can arise from different wall layers in the esophagus (Table 18-6). These tumors are usually asymptomatic and slow growing, noted only as incidental findings during routine radiography or endoscopy. Occasionally, they may be discovered during the evaluation of dysphagia or vague chest discomfort. The most common benign esophageal tumor is the leiomyoma. Because the tumor arises from the muscularis propria, it is covered by an intact submucosa and mucosa, making it difficult to biopsy endoscopically.

    Inflammatory polyps and granulomas can arise in the setting of esophagitis and may be confused with malignant lesions from time to time. Endoscopic removal is possible, although usually not indicated. Endoscopic biopsy and regression with therapy for esophagitis clearly distinguish the clinical course of inflammatory polyps and granulomas from cancers.

    Clinical Findings

    A. Symptoms and Signs

    Although the vast majority of benign esophageal tumors are clinically silent and go undetected, large or strategically located tumors may become symptomatic. Similar to their malignant counterparts, dysphagia is the most common presentation for patients with benign esophageal tumors. Less common presenting symptoms include odynophagia, retrosternal pain or thoracic pressure, food regurgitation, anorexia, and weight loss. Respiratory complaints such as cough, dyspnea, or sore throat may also contribute to the presentation. Occasionally, leiomyomas can outgrow their own blood supply, leading to necrosis and ulceration of the overlying mucosa and resulting in overt GI hemorrhage such as hematemesis or melena.

    B. Imaging

    Endoscopic appearance and biopsy can identify some benign esophageal tumors. However, EUS provides high-resolution images that define the individual esophageal wall layers and can readily identify lesions in the deeper layers (ie, submucosa and muscularis propria) that elude endoscopic biopsy diagnosis.

    If necessary, EUS-guided FNA can be performed for diagnostic purposes. Leiomyomas are generally noted as hypoechoic mass lesions within the muscularis propria. Occasionally, the echopattern is more heterogeneous, which may indicate hemorrhage into the tumor. Cystic lesions may appear as anechoic structures within the mucosa and submucosa, whereas inflammatory growths are always superficial and localized to the mucosa.


    Small, mucosal-based and submucosal esophageal tumors can be removed endoscopically using EMR techniques or possibly obliterated by endoscopic injection of sclerosants or by APC. Larger mass lesions, especially leiomyomas, are generally removed surgically if they are associated with severe symptoms or other complications, eg, bleeding. In many instances, the resection can now be accomplished by minimally invasive techniques.


    Bancewicz J: Palliation in esophageal neoplasia. Ann R College Surgeons Engl 1999;81:382.

    Blot W, McLaughlin J: The changing epidemiology of esophageal cancer. Semin Oncol 1999;26(5, Suppl 15):2.

    Bollschweiler E et al: Preoperative risk analysis in patients with adenocarcinoma or squamous cell carcinoma of the esophagus. Br J Surg 2000;87:1106.

    Brierley J, Oza A: Radiation and chemotherapy in the management of malignant esophageal strictures. Gastrointest Endosc Clin North Am 1998;8(2):451.

    Bytzer P et al: Adenocarcinoma of the esophagus and Barrett's esophagus: a population-based study. Am J Gastroenterol 1999;94(1):86.

    Chalasani N, Wo J, Waring J: Racial differences in the histology, location, and risk factors of esophageal cancer. J Clin Gastroenterol 1998;26(1):11.

    Chow W et al: Body mass index and risk of adenocarcinoma of the esophagus and gastric cardia. J Natl Cancer Inst 1998;90(2):150.

    Choy H: Taxanes in combined-modality therapy for solid tumors. Oncology 1999;13(10, Suppl 5):23.

    DeCamp M, Swanson S, Jaklitsch M: Esophagectomy after induction chemoradiation. Chest 1999;116(6, Suppl):466S.

    Devesa S, Blot W, Fraumeni J: Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998;83(10):2049.

    Dolan K et al: New classification of esophageal and gastric carcinomas derived from changing patterns in epidemiology. Br J Cancer 1999;80(5/6):834.

    Ell C et al: Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett's esophagus. Gastroenterology 2000;118:670.

    El-Serag H, Sonnenberg A: Ethnic variations in the occurrence of gastroesophageal cancers. J Clin Gastroenterol 1999;28(2):135.

    Enzinger P, Ilson D, Kelsen D: Chemotherapy in esophageal cancer. Semin Oncol 1999;26(5, Suppl 15):12.

    Greenlee RT et al: Cancer statistics, 2000. CA: Cancer J Clinicians 2000;50:7.

    Hansen S et al: Esophageal and gastric carcinoma in Norway 1958-1992: incidence time trend variability according to morphological subtypes and organ subsites. Int J Cancer 1997;71:340.

    Heath E et al: Adenocarcinoma of the esophagus: risk factors and prevention. Oncology 2000;14(4):507.

    Kubba A, Poole N, Watson A: Role of p53 assessment in management of Barrett's esophagus. Dig Dis Sci 1999;44(4):659.

    Launoy G et al: Alcohol, tobacco and esophageal cancer: effects of the duration of consumption, mean intake and current and former consumption. Br J Cancer 1997;75(9):1389.

    Lerut T et al: Treatment of esophageal carcinoma. Chest 1999;116 (6, Suppl):463S.

    Lightdale C: Role of photodynamic therapy in the management of advanced esophageal cancer. Gastrointest Endosc Clin North Am 2000;10(3):397.

    Mayoral W, Fleischer D: The esophacoil stent for malignant esophageal obstruction. Gastrointest Endosc Clin North Am 1999;9(3):423.

    Meyenberger C, Fantin AC: Esophageal carcinoma: current staging strategies. Recent Results Cancer Res 2000;155:63.

    Minsky B: Carcinoma of the esophagus. Part 1: Primary therapy. Oncology 1999;13(9):1225, 1235.

    Minsky B: Carcinoma of the esophagus. Part 2: Adjuvant therapy. Oncology 1999;13(10):1415.

    Noguchi H et al: Evaluation of endoscopic mucosal resection for superficial esophageal carcinoma. Surg Laparosc Endosc Percutan Tech 2000;10(6):343.

    Patti M, Owen D: Prognostic factors in esophageal cancer. Surg Oncol Clin North Am 1997;6(3):515.

    Ponchon T: Endoscopic mucosal resection. J Clin Gastroenterol 2001;32(1):6.

    Pompili M, Mark J: The history of surgery for carcinoma of the esophagus. Chest Surg Clin N Am 2000;10(1):145.

    Radu A et al: Photodynamic therapy of early squamous cell cancer of the esophagus. Gastrointest Endosc Clin North Am 2000;10(3):439.

    Rosch T: The new TNM classification in gastroenterology (1997). Endoscopy 1998;30(7):643.

    Rudolph R et al: Effect of segment length on risk for neoplastic progression in patients with Barrett's esophagus. Ann Intern Med 2000;132(8):612.

    Sharma V et al: Changing trends in esophageal cancer: a 15 year experience in a single center. Am J Gastroenterol 1998;93:702.

    Soetikno R, Inoue H, Chang K: Endoscopic mucosal resection - current concepts. Gastrointest Endosc Clin North Am 2000;10(4):595.

    Streitz J et al: Endoscopic surveillance of Barrett's esophagus: a cost-effectiveness comparison with mammographic surveillance for breast cancer. Am J Gastroenterol 1998;93(6):911.

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