Laparoscopic enucleation of a giant submucosal esophageal lipoma. Case report and literature review

Patient: Female, 40 Final Diagnosis: Esophageal lipoma Symptoms: — Medication: — Clinical Procedure: Laparoscopic enucleation Specialty: Surgery Objective: Rare disease BACKGROUND: Benign tumors of the esophagus are very rare, constituting only 0.5% to 0.8% of all esophageal neoplasms. Approximately 60% of benign esophageal neoplasms are leiomyomas, 20% are cysts, 5% are polyps, and less than 1% are lipomas. CASE REPORT: A 40-year-old woman was referred to our department with dysphagia that had progressively worsened during the previous 2 years. Physical examination on admission produced normal findings. Upper gastrointestinal endoscopy revealed a submucosal space-occupying mass in the posterior wall of the lower esophagus, with normal mucosa. The mass was yellowish and soft. A computed tomography (CT) of the chest revealed a submucosal esophageal lesion in the posterior wall, with luminal narrowing of the distal esophagus. Thus, a submucosal tumor was identified in this region and esophageal submucosal lipoma was considered the most likely diagnosis. A laparoscopic operation was performed. The tumor was completely enucleated, and measured 10×7×2.5 cm. The pathology showed lipoma. The postoperative course was uneventful, and the patient was discharged 4 days after the operation. CONCLUSIONS: Benign tumors of the esophagus are very rare. Laparoscopic transhiatal enucleation of lower esophageal lipomas and other benign tumors is a safe and effective operation.