Complex diagnostics and treatment of rare esophageal tumor (clinical case)
Abstract
Cavernous hemangioma of the esophagus is an extremely rare benign vascular neoplasm, often asymptomatic and may be detected accidentally while performing instrumental study for another reason.
Aim – a rare clinical case report of esophageal cavernous hemangioma comprehensive diagnostics and treatment.
Material and methods. In January 2017 during an endoscopy the lesion of the lower third of the esophagus was detected in a 47-year-old patient. In 2014, in another medical institution during endoscopy by reason of anemia of unknown cause (the decrease in hemoglobin 87 g/l, according to the patient), the submucosal tumor of the esophagus was detected for the first time and suggested to have a vascular genesis. Biopsy was not performed to avoid the risk of bleeding.
Results. A comprehensive examination was performed, including endoscopy and computed tomography (CT). CT scan revealed thickening of the walls of the esophagus due to soft-tissue structures with multiple calcium inclusions. According to the endoscopy of the esophagus there was a bumpy lesion, covered by smooth mucosa, with white color area 3–4 mm in diameter. Part of the lesion was bluish color, soft-elastic consistence with instrumental palpation and significantly flattened with air insufflation. According to endoscopy ultrasonography the tumor was associated with muscular layer, spread over a half of the circumference of the esophagus. Submucosa was thickened in the area of tumor. The lesion had hypoechogenic heterogeneous structure due to multiple hyperechoic inclusions (calcification), the blood flow was not observed during the color doppler. The patient underwent thoracoscopic surgery and cavernous hemangioma with calcification was detected in the muscular layer of the esophagus.Conclusion. Cavernous hemangioma of the esophagus is a very rare neoplasm, usually asymptomatic. Early diagnosis and treatment of hemangioma of the esophagus is important to prevent bleeding.
Research design – a rare clinical case report. Level of evidence II.
Keywords:cavernous hemangioma of the esophagus, endoscopy ultrasonography
Clin. Experiment. Surg. Petrovsky J. 2018; 6 (2): 87–92.
doi: 10.24411/2308-1198-2018-12012. Received: 04.04.2018. Accepted: 20.04.2018.
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