Benign Esophageal Tumors

Sometimes a tumor develops in your esophagus that is not cancerous (benign). The most common type—representing about 70 percent of benign tumors—is leiomyoma, which forms in the muscle. Doctors do not know what causes benign esophageal tumors. When these tumors are small, you may not have any symptoms. We may not need to treat these, though we will check you periodically to see if the tumors have grown.

It is also possible that you may develop a cyst in your esophagus. Simple cysts are sacs filled with fluid. Esophageal duplication happens when the middle layer of the esophagus forms an extra layer, creating a “bump” or growth. Both types of cysts can develop anywhere along the esophagus.

As esophageal tumors grow, you may experience these effects:

• Bleeding
• Chest pain
• Difficulty swallowing
• Food getting stuck in the back of your throat
• Sudden back-up of undigested food (regurgitation)
• Ulcers (sores) in the esophagus

To diagnose benign esophageal tumors, we may use several tests:

• Blood tests: Can tell us how well your organs are functioning.
• Barium swallow: After you drink a smooth chalky liquid of barium, which coats the inside of your organs, we do a series of X-rays. These X-rays show us the size and location of your tumor, whether your esophagus is tightening, and if there is a break in the esophagus (ulceration).
• Endoscopic ultrasound: An imaging test that shows the location, size, and depth of the tumor. We can also tell if the tumor has spread to surrounding lymph nodes or tissues.
• Other imaging tests. Scans such as a positron emission tomography (PET) or magnetic resonance imaging (MRI) can help us see your condition.
• Upper gastrointestinal endoscopy: Using a narrow tube with a light and camera on the end, we can see your esophagus, stomach, and duodenum. We can also take a tissue sample for a biopsy if necessary.

Treatment We Offer

If a benign esophageal tumor is large or causing symptoms, we may need to treat it surgically. Whenever possible, we try to use a minimally invasive approach. These techniques help you feel better faster, spend less time in the hospital, and have smaller scars.

• Enucleation: The goal with this procedure is to remove the tumor from the esophageal wall while leaving the esophagus intact. At Mount Sinai, we use a minimally invasive procedure called video-assisted thoracoscopic surgery (VATS). We make small incisions in the side of the chest and, using a tiny camera and tiny instruments, we remove the tumor from your esophagus. You should be home within a day or two after the procedure.
• Esophagectomy: This procedure is intended for people who are not candidates for enucleation. We make an incision in your chest and remove part or all of your esophagus. You will be in the hospital for eight to ten days after the procedure. You may need to use a feeding tube for four to six weeks. After that, you will be able to eat whatever you like, but in smaller, more frequent meals.