What are the other Names for this Condition? (Also known as/Synonyms)

• Esophageal Hemangioma
• Haemangioma of Esophagus
• Oesophageal Hemangioma

What is Hemangioma of Esophagus? (Definition/Background Information)

• Hemangiomas are benign accumulations of blood vessels, which can occur in several tissues such as the brain, kidney, liver, lung, skin (cherry), and nasal cavity
• Hemangioma of Esophagus is a benign vascular tumor that forms in the esophagus. The esophagus is a part of the upper gastrointestinal tract and is also known as the ‘food-pipe’
• Esophageal Hemangiomas may be either of the two types - cavernous or capillary. They are mostly observed in elderly men and women
• The cause of formation and risk factors for Hemangioma of Esophagus are unknown. It is believed to abnormally arise during fetal growth and development
• Most small tumors are asymptomatic and painless, though the larger ones may compress the surrounding structures and cause related signs and symptoms
• Hemangioma of Esophagus may be diagnosed by evaluating the clinical history and a thorough physical exam, followed by imaging studies, such as CT and MRI scans of the chest
• The treatment techniques for tumors causing significant symptoms may include removal through endoscopic surgery. In some cases, the healthcare provider may recommend a ‘wait and watch’ approach to monitor the tumor. The prognosis of Hemangioma of Esophagus is mostly good with appropriate treatment

Who gets Hemangioma of Esophagus? (Age and Sex Distribution)

• Hemangioma of Esophagus is mostly observed in older adults, although individuals of a wide age range may be affected
• More cases are reported in males than females
• No racial or ethnic predilection is observed

What are the Risk Factors for Hemangioma of Esophagus? (Predisposing Factors)

• Currently, no definitive risk factors are known for Hemangioma of Esophagus

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hemangioma of Esophagus? (Etiology)

• Currently, there are no identified causes for the development of Hemangioma of Esophagus
• Researchers believe that it could develop as a malformation during fetal development

What are the Signs and Symptoms of Hemangioma of Esophagus?

Some small-sized Hemangiomas of Esophagus may not cause any significant symptoms and are detected incidentally. In others, the following signs and symptoms may be noted:

• Swallowing difficulty may occur from large-sized tumors
• Most tumors are 1-3 cm in size and observed on the esophageal wall
• Some tumors can grow to very large sizes
• The tumors are typically solitary, soft, and polyp-shaped
• Some hemangiomas can bleed and lead to complications

How is Hemangioma of the Esophagus Diagnosed?

A diagnosis of Hemangioma of Esophagus would involve:

• Physical exam and evaluation of medical history
• X-ray of the chest
• CT or MRI scan of the chest
• Upper GI endoscopy: An endoscopic procedure is performed using an instrument called an endoscope, which consists of a thin tube and a camera. Using this technique, the radiologist can have a thorough examination of the insides of the upper gastrointestinal tract
• Endoscopic ultrasonography: During this procedure, fine needle aspiration biopsy (FNAB) can be performed on the affected area. This is good technique for tumor detection
• A tissue biopsy of the tumor (polyp) is performed and sent to a laboratory for a pathological examination
  • A pathologist examines the biopsy under a microscope. If it is indeed a polyp, a distinct appearance is noted by the pathologist. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
  • Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
  • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
  • Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hemangioma of Esophagus?

The complications of Hemangioma of Esophagus are normally rare; but, in some cases, large tumors may cause the following complications:

• Large-sized tumors may compress adjoining tissues and structures resulting in additional complications
• Ulceration and bleeding, which can rarely be life-threatening
• Severe obstruction of the food-pipe with pain, leading to difficulties in eating
• Stricture formation of esophagus
• Damage to the muscles, vital nerves, and blood vessels, during surgery
• Post-surgical infection at the wound site is a potential complication

How is Hemangioma of Esophagus Treated?

Due to the benign (non-cancerous) nature of Hemangioma of Esophagus, small-sized tumors do not generally require any treatment. However, they may be removed to confirm the diagnosis.

• In some cases, the healthcare provider may recommend a ‘wait and watch’ approach for small-sized tumors
• A complete surgical resection of the tumor (endoscopic polypectomy) is usually curative. It is normally undertaken when significant symptoms are observed
• Arterial embolization of the tumor may be used to provide temporary relief from the symptoms, and reduce blood loss during ‘tumor removal’ surgical procedure
• Radiation therapy may be planned on a case-by-case basis
• Post-operative care is important: One must maintain minimum activity levels, until the surgical wound heals
• Follow-up care with regular screening and check-ups are important

How can Hemangioma of Esophagus be Prevented?

• Current medical research has not established a method of preventing the formation of Hemangioma of Esophagus
• Regular medical screening at periodic intervals with blood tests, radiological scans, and physical examinations, for those who have already endured the tumor, are helpful

What is the Prognosis of Hemangioma of Esophagus? (Outcomes/Resolutions)

• The prognosis of Hemangioma of Esophagus is typically good with adequate treatment; a full recovery is often ensured and no long-term complications are noted
• Endoscopic surgery is the most reliable treatment tool to completely remove the tumor and prevent any recurrences from taking place

Additional and Relevant Useful Information for Hemangioma of Esophagus:

The following DoveMed website links are useful resources for additional information:

http://www.dovemed.com/diseases-conditions/cancer/