Successful removal of a giant esophageal lipoma by thoracoscopic enucleation: a case report

Wataru Goto,Yutaka Tamamori,Katsunobu Sakurai,Kiyoshi Maeda,Naoshi Kubo,Masaichi Ohira

doi:10.1186/s40792-020-0782-7

Wataru Goto, Yutaka Tamamori + Show 4 more

Open Access

https://doi.org/10.1186/s40792-020-0782-7

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Abstract

BackgroundWe report a rare case of giant esophageal lipoma treated with thoracoscopic enucleation successfully.Case presentationA 69-year-old woman was referred to our department with dysphagia. Computed tomography examination revealed a large hypoattenuating submucosal mass with dense fat in the middle and lower esophagus. Upper gastrointestinal endoscopy revealed a submucosal mass with normal mucosa on the middle and lower esophageal wall. On a diagnosis of esophageal lipoma, we performed a video-assisted thoracoscopic operation and the 14.0 × 6.5 × 3.0 cm in size submucosal tumor was completely enucleated. We could successfully avoid a subtotal esophagectomy with high invasiveness. The patient was discharged on the 36th day after operation, and no symptoms had been noted.ConclusionsVideo-assisted thoracoscopic enucleation with minimal invasiveness may be an appropriate treatment option even for such a huge benign esophageal submucosal tumor.

Highlights

We report a rare case of giant esophageal lipoma treated with thoracoscopic enucleation successfully
Esophageal submucosal tumors represent less than 1% of all esophageal neoplasms [2]
If a small submucosal tumor is located on the left wall of the esophagus, it is considered possible to perform minimally invasive surgery by enucleation with the left-side transthoracic approach

Summary

Background

Benign tumors of the esophagus are very rare. Esophageal lipomas, in particular, account for only 0.4% of all digestive tract benign tumors [1]. Because most esophageal lipomas are small and asymptomatic, many cases are found incidentally during imaging studies. Esophageal lipomas become large and tend to produce symptoms such as dysphagia, and surgical excision is required. We report a rare case of giant esophageal lipoma treated with thoracoscopic enucleation successfully. Physical examination on admission revealed normal findings. A chest computed tomography (CT) scan revealed a 10 × 7 cm submucosal mass in size. Upper gastrointestinal endoscopy 8 days after the operation showed anastomotic ulcer and reflux esophagitis (Fig. 4a). These were gradually improved by administration of omeprazole.

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Funding None