Case report: Lymphangioma of the oesophagus endoscopically resected

Abstract

Lymphangioma of the oesophagus is an extremely rare entity, with only nine cases having been reported worldwide. We report on a 52-year-old woman with oesophageal lymphangioma, diagnosed using endoscopic ultrasonography and endoscopically resected. No case of malignant transformation of the lymphangioma has been reported in the literature. Endoscopic resection seems to be a minimally invasive method that is appropriate both for the removal of the tumour and precise diagnosis.

Endoscopic submucosal dissection of esophageal lymphangioma: a case report with a review of the literature

“…It is necessary to differentiate these tumors from other submucosal tumors, such as hemangiomas. EUS is useful for distinguishing lymphangioma from leiomyoma and other submucosal tumors, since it clearly exhibits cyst formation and intact esophageal musculature [8]. In the current case, however, we failed to demonstrate cystic findings by EUS probably because the resolution was insufficient.…”

“…Treatment should be considered when a tumor increases in size or changes in shape in patients without definitive histological diagnosis of lymphangioma, or in patients who have symptoms due to these tumors. There have been eight case reports of endoscopic treatment [snarepolypectomy and endoscopic mucosal resection (EMR)] of these lesions (Table 1) [4,6,8,9,[11][12][13][14][15][16][17][18][19][20][21][22]. If the tumor is small, it can be resected by EMR [8].…”

Oesophageal lymphangioma: an exceedingly rare tumour

“…Endoscopic resection is an appropriate, safe and minimally invasive option for removal of oesophageal lymphangiomas under 2.5 cm in size 4 15 18. Large submucosal oesophageal lymphangiomas with a flat configuration are best managed by endoscopic submucosal dissection, as recently reported by Arashiro et al 23.…”

“…EUS is the most useful examination for distinguishing lymphangioma from leiomyoma and other subepithelial tumours because it accurately shows the cystic nature of lymphangioma and whether the oesophageal muscles are intact, which is necessary for the tumour to be amenable to endoscopic resection 4 15 18 23. Although a multicystic pattern within the third layer or submucosa is considered a feature of lymphangioma,4 not all lymphangiomas have this internal echo structure,4 23 because the tumour structure may vary in accordance with the size of the dilated lymphatic vessels 4.…”

Lymphangioma of esophagus presenting with dysphagia: A case report

“…Safe endoscopic resection of esophageal lymphangioma of less than 25 mm in diameter has been reported by Suwa and associates. [12] Kuramoto and associates [13] have stated that lymphangiomas less than 20 mm in diameter can be treated by endoscopic resection. However, a large tumor with symptoms or a lesion suspicious for malignancy requires surgical resection.…”