Cervical esophageal hemangioma is a rare benign tumor. Symptoms may include hematemesis, dyspnea, cough, dysphagia, and chest pain.

To describe a case of a large esophageal hemangioma in order to raise awareness of the condition and highlight the use of a cooperative endoscopic treatment approach by a gastroenterologist and otolaryngologist with excellent results. The literature on large esophageal hemangioma is reviewed.

An otherwise healthy male presented with a huge hemangioma of the upper esophagus. Imaging showed the mass hanging on a narrow stalk attached to the posterior wall of the cricopharyngeus muscle, filling the lumen of the cervical and mediastinal esophagus. Resection was accomplished with a combination of flexible gastroscopy and microscope-assisted rigid direct laryngoscopy.

Pathologic evaluation showed a polypoid mass covered with squamous epithelium, with multiple engorged blood vessels. Some of the vessels were wide, surrounded by a thin wall, and others were narrow with a thick wall. The histology was compatible with arteriovenous hemangioma. There was no evidence of malignancy. At the 7-month postoperative follow-up, the patient appeared well, with no dyspnea or dysphagia. Our literature search yielded only two published cases of a huge hemangioma of the upper esophagus, which were treated by open resection. Ours is the first report of the use of endoscopic excision.

Large esophageal hemangioma should be part of the differential diagnosis of dyspnea, dysphagia, persistent cough, or chest pain. A combined approach by a gastroenterologist and otolaryngologist, working cooperatively, can facilitate the correct diagnosis and provide optimum treatment.

Alkan U, Geller A, Shvero J. Patient with Huge Upper Esophageal Hemangioma. Int J Otorhinolaryngol Clin 2017;9(1):25-27.