Diagnosis and management of benign esophageal tumors

BENIGN ESOPHAGEAL tumors are much less common than malignant ones. Their clinical presentations have important differences from malignant lesions, but on an individual basis, too much overlap exists to allow diagnosis on clinical grounds alone. Barium swallow and endoscopy are required to differentiate benign tumors and allow histologic classification. Three histologic types account for 87% of benign esophageal masses (leiomyomas, cysts, and polyps). All symptomatic benign tumors should be removed by enucleation, endoscopic snare, or limited resection, depending on the histologic type, size, and intramural location. Asymptomatic esophageal lesions of certain histologic types should be moved (leiomyomas, cysts, and polyps), although others (hemangiomas, papillomas, and granular cell myoblastomas) can simply be observed if the risks of removal are too high.