Benign Esophageal Tumors
Some patients can develop tumors in the esophagus which are benign. These are relatively rare. The most common of these is called leiomyoma, a benign smooth muscle tumor, and accounts for approximately 70 percent of these tumors. Usually these are small and asymptomatic. Symptoms usually occur once they are at least 5 cm in size. Symptoms can include difficulty swallowing and chest pain. Diagnosis is best made with a swallow study – a smooth defect in the esophagus – and with an endoscopy. These tumors are located within the wall of the esophagus and do not invade into the esophageal lumen (cavity) or outside the esophagus. Tumors that do invade the esophageal lumen are most likely not benign.
Surgical therapy is indicated when they are large enough or when they are symptomatic. Usually this is achieved by enucleation – removing the tumor from the esophageal wall while leaving the esophagus intact. At Mount Sinai, we perform this with minimally invasive surgery (VATS). This operation is achieved by making small incisions in the side of the chest and, with the use of a camera and instruments, the tumor is removed from the esophagus. For those that are not candidates for enucleation, an esophagectomy may be required. Patients are usually discharged home in 1-2 days for enucleation and 8-10 days for esophagectomy. The small incisions are barely visible within several weeks of the operation.