Benign esophageal tumors are rare and can be classified based on their origin into intraluminal tumors (such as polyps and papillomas), submucosal tumors (such as hemangiomas and granular cell myoblastomas), and intramural tumors (such as esophageal leiomyomas or esophageal stromal tumors). Among these, intramural tumors account for approximately three-quarters of benign esophageal tumors.
The symptoms and clinical signs of patients with benign esophageal tumors primarily depend on the location and size of the tumor. Larger tumors may cause varying degrees of esophageal obstruction, leading to symptoms such as dysphagia, vomiting, and weight loss. Many patients also experience aspirational pneumonia, retrosternal pressure, or chest pain. Hemangiomas may cause bleeding.
The diagnosis of benign esophageal tumors can typically be established by imaging studies (such as a barium esophagogram or chest CT scan) and endoscopic examination, regardless of whether the patients exhibit symptoms. Esophageal leiomyomas and esophageal stromal tumors are the most frequently encountered forms of benign esophageal tumors and are located in the muscular layer. The mucosa remains intact, and the tumors vary in size and shape, presenting as oval, ginger-shaped, or spiral-shaped masses. Barium esophagograms may reveal “crescent-shaped” impressions. Endoscopic examination often shows smooth and normal mucosa over the surface of the tumor. It is important to avoid mucosal biopsy, which may damage the mucosa.
Surgical treatment is generally effective for benign esophageal tumors. Small, pedunculated intraluminal tumors may be removed endoscopically. Intramural and submucosal tumors are typically excised using thoracoscopic or open thoracic surgery. During surgery, protecting the esophageal mucosa to prevent damage is crucial. Surgical outcomes for benign esophageal tumors are favorable, with excellent prognoses and very rare instances of malignant transformation.