Mobile upper oesophageal lipoma causing airway obstruction

Area of Science:

• Gastroenterology
• Otolaryngology
• Surgical Oncology

Background:

• Upper esophageal lipomas are rare benign tumors.
• Mobile submucosal lipomas can present with fluctuating symptoms.
• Intermittent prolapse into the hypopharynx and supraglottis can cause acute airway obstruction.

Purpose of the Study:

• To report a case of a mobile upper esophageal lipoma causing intermittent dysphagia and airway obstruction.
• To highlight the diagnostic challenges associated with such elusive lesions.
• To discuss the surgical management of upper esophageal lipomas.

Main Methods:

• Case presentation of a previously well male patient.
• Diagnostic workup including esophagoscopy.
• Management involved local anesthetic tracheostomy and subsequent surgical excision via external approach esophagotomy.

Main Results:

• The lipoma caused intermittent dysphagia and acute airway obstruction due to supraglottic herniation.
• Endoscopic identification was challenging due to the lesion's mobility.
• Surgical excision via external approach esophagotomy resulted in complete resolution of symptoms.

Conclusions:

• Mobile upper esophageal lipomas pose diagnostic and management challenges due to their fluctuating presentation.
• Delayed diagnosis can result from the intermittent nature of symptoms.
• Transcervical esophagotomy is a viable surgical option when endoscopic management is unsuccessful.