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J Thorac Cardiovasc Surg 2007;133:1665-1667
© 2007 The American Association for Thoracic Surgery

Brief Communication

Giant cavernous hemangioma of the distal esophagus treated with esophagectomy

Department Cardiothoracic Surgery, Weill Medical College of Cornell University, New York, NY.

Received for publication January 16, 2007; accepted for publication February 12, 2007.

^_* Address for reprints: Anthony W. Kim, MD, Rush University Medical Center, 1725 W Harrison St, Suite 774, Chicago, IL 60612. (Email: Anthony_kim@rush.edu).

The first 20% of the full text of this article appears below.

Giant cavernous hemangiomas are rare tumors of the esophagus. In 1976, Feist, Talley, and Hunt¹ described an upper esophageal hemangioma as "giant"; it was preoperatively 4 x 7 cm and pathologically 12.0 x 5.0 x 2.5 cm in size. We present the case of an asymptomatic 68-year-old woman who had a giant hemangioma of the distal esophagus. She underwent an esophagectomy with a gastric pull-up via a left thoracotomy. Her recovery was unremarkable and she is doing well at 4 months’ follow-up.

Clinical Summary

A 68-year-old asymptomatic woman was found to have an abnormality on a chest radiograph before cataract surgery. A follow-up computed tomographic (CT) scan demonstrated a large lobulated distal esophageal mass with multiple small calcifications (Figure 1). Endoscopy was negative for mucosal lesion. A positron emission tomographic (PET) scan revealed that the mass had a standardized uptake value of 2.0. A transthoracic biopsy of the lesion demonstrated only blood and fibrinated material. Magnetic resonance imaging (MRI) reidentified the lobulated soft tissue mass in the distal esophagus and described it as a fusiform lesion involving the esophageal wall, causing narrowing of the lumen. Neither mediastinal invasion nor lymphadenopathy was noted. On the basis of the soft tissue signal and the smooth appearance, the lesion was thought to be a large leiomyoma.

View larger version (110K):   Figure 1. Computed tomographic scan demonstrating a large circumferential distal esophageal hemangioma with multiple small calcifications.