Benign Esophageal Tumors

Benign esophageal tumors are rare (1% of esophageal tumors); younger age than esophageal cancer; slow progression; long course. Most common: leiomyoma (~90%); also mucosal/submucosal polyps, lipomas, fibrolipomas, papillomas. Esophageal leiomyoma: middle-aged males; lower/mid esophagus; almost always solitary. Arises from muscularis, grows intramurally/extraluminally, mucosa intact (no hematemesis). Round/oval/horseshoe, complete capsule, firm, gray-white whorled cut surface, 2-5cm (up to 10+cm, encircling long esophageal segment).

Common Symptoms

Weight loss; choking on swallowing; chest discomfort with dry food; retrosternal pain

Causes and Pathogenesis

Benign tumors of esophageal muscularis. Age 20-60; mid/lower esophagus. Solitary 2-5cm (some >10cm). Spherical/ovoid/lobulated, firm, yellow-white cut surface, clear border, poor vascular supply. Microscopy: long spindle cells, abundant cytoplasm, spindle/rod nuclei, no atypia, smooth-muscle bundles; rare malignant change. Small tumors asymptomatic/ mild (dysphagia/retrosternal dull pain); large upper tumors may compress trachea → dyspnea. X-ray: oval/semilunar filling defect, smooth mucosa, normal peristalsis, acute angle at margins; large tumors bulge into mediastinum. Polyps: large/inflamed → dysphagia/upper abdominal/retrosternal pain; mucosal erosion → bleeding; long pedunculated polyps may protrude from mouth, even obstruct larynx → asphyxia. Diagnosis by barium swallow + esophagoscopy. Cysts: congenital vs acquired (retention cysts from duct atresia); congenital more common; viscous/hemorrhagic fluid; symptoms vary with size/compression/infection. Hemangiomas: mid-esophagus, fungating/lobulated, bright red/purple; hematemesis/melena/dysphagia. Papillomas: sessile, from lamina propria, fibrovascular core covered by proliferating squamous epithelium; verrucous/nodular/cauliflower/diffuse; diagnosis by esophagoscopy + deep biopsy.

Treatment

Surgery, drug, supportive therapy

Preventive Measures

(1) Stop smoking, diet, exercise, weight control. (2) Immune health: diet/exercise/stress control; positive mood + exercise.

Department to Visit

It is recommended to visit the Surgical Oncology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.