There are many types of benign esophageal tumors; many are found incidentally, remain asymptomatic, and warrant only observation. Some can cause swallowing symptoms and rarely ulceration or bleeding.
Diagnosis of Benign Esophageal Tumors
Barium esophagram or upper GI endoscopy
Initial evaluation typically mirrors that of dysphagia, beginning with a barium esophagram or upper GI endoscopy (with or without endoscopic ultrasonography).
Once a lesion is visualized, tissue samples can be obtained with upper endoscopy.
A CT scan may be helpful in some cases for initial characterization and to monitor changes over time.
Treatment of Benign Esophageal Tumors
Surgical or endoscopic removal
Generally, treatment is recommended when benign tumors continue to enlarge or patients become symptomatic.
Leiomyoma, the most common benign esophageal tumor, may be multiple and can become large. Depending on its size and location, the tumor can be excised or enucleated. Minimally invasive approaches such as endoscopic submucosal dissection and video-assisted thoracoscopic surgery (VATS) have increasingly replaced open thoracotomy in many cases, thus reducing operative morbidity. With treatment, this tumor usually has an excellent prognosis.
Esophageal papillomas and granular cell tumors, although rare, may become malignant and their complete endoscopic removal is recommended.
