Fibroma in the esophagus. Esophageal cysts (enterogenic cysts)

Diseases of the esophagus (surgery is sometimes inevitable) can pose a great danger to human health and life.

Syntopy of the esophagus: three sections are distinguished. Cervical (5 cm) is behind the trachea. It starts at the level of 6-7 vertebrae and ends at the level of the 2nd. thoracic(from 15 before 18 cm) ends at the opening of the esophageal diaphragm. Abdominal the shortest section 1 before 3 cm. The department is located under the diaphragm, closed by the left side of the liver. Expands slightly as it passes into the stomach.

Diseases of the esophagus: classification

Ailments and disorders are represented by a large spectrum and are divided into three large groups. Classification of diseases and disorders.

Disorders belong to the group of functional diseases, divided into central, peripheral and iatrogenic. Among the main ones:

1. may be felt intermittently or continuously, or between meals.
2. regurgitation ( rumination syndrome), when recently eaten food is partially returned to the oral cavity. In this case, re-swallowing occurs, nausea and vomiting are absent. When food becomes sour, regurgitation stops.
3. Pain behind the sternum, without a burning sensation. At the same time, as a reason, there are no any violations of motor skills.
4. Heartburn felt in the chest. The disorder is accompanied by burning. In this case, esophageal motility disorders are not observed.
5. Dysphagia- these are sensations of poor passage of any food through the esophageal tube, its delay along the way. It happens temporarily.

Diseases of the esophagus (symptoms, treatment - the two most important issues) are accompanied by excruciating, indefinite pains that migrate through the organ, personality disorders. In this case, changes in the organ are not detected.

Causes of the development of diseases, diagnosis

The main diseases of the esophagus, the symptoms, the signs of which are varied, may appear due to various factors:

1. Congenital diseases occur during the prenatal period. The main malformations of the esophagus appear due to genetic abnormalities. They may be due to diseases of the pregnant woman or the peculiarities of the course of the period of bearing a child.
2. The causes of the mechanical nature of the damage include any injuries that a person received while eating (chicken and fish bones, objects, large pieces of solid food that were not chewed, etc.).
3. The use of excessively hot or spicy food, alcoholic beverages, poisoning with toxic substances, etc. form thermal and chemical factors.
4. Infectious causes include poorly healed diseases, inflammation of the tonsils, etc.

To determine the cause of the disease of diseases of the esophagus -, daily pH-metry, esophagotonokymography. The procedure of esophagoscopy, radioisotope research, functional testing is also done. If a tumor is suspected, computed tomography is performed or.

Symptoms and treatment of congenital anomalies

The main malformations of the body include atresia. She is dating. With atresia, the upper part of the organ does not work, and the lower part is connected to the trachea. The anomaly develops in the first stages of pregnancy, when the internal organs of the fetus are still being laid.

Symptoms and treatment of esophageal tube disease with anomalies - after birth, the child has difficulty breathing, foam appears in the mouth. A little later, regurgitation and coughing begin. The restoration of the organ is long, carried out in early childhood.

short esophagus

A short organ is also often found Barrett. This is a congenital anomaly in which the organ is constantly open. As a result, he is absolutely not protected from the stuffing of the gastric mass. Symptoms and treatment of the disease: a person with a short organ constantly feels heartburn, vomiting with blood appears, and problems with nutrition. The anomaly is usually treated with surgery.

ectopia

Ectopic esophagus - what is it? This is the displacement of an organ or tissues outward or into adjacent cavities. ectopia observed with a short organ. This is a precancerous condition in which cylindrical "islands" of the epithelium appear. Ectopia cannot always be cured with surgery.

Esophageal cyst: symptoms

It refers to cancer. The tumor is a thin-walled formation with a light viscous liquid. The cyst does not grow to a large size. Most often, the tumor appears in men, in the middle and lower parts of the esophageal tube.

Signs of a disease of the esophagus - a person first feels a general malaise, loses appetite. At the same time, body weight is sharply reduced. There are changes that are characteristic of a malignant neoplasm. Among the manifestations is a sharp bend in the esophagus (the symptoms are varied), and they are multiple, narrowing of its gaps. Fluoroscopic examination reveals rigid or non-peristaltic areas. Symptoms of a cyst during the progression of oncology:

At the first symptoms, for the treatment of diseases of the stomach and esophagus (symptoms, treatment - two important issues), you should immediately consult a doctor. Ectopia affects neighboring cells, dysbacteriosis begins, then the growth of a cancerous tumor may follow. The effectiveness of treatment depends on the timing of symptoms of an esophageal tube problem. With late detection of the tumor, treatment becomes ineffective.

Neurosis of the esophagus: symptoms

Neurosis cause psychological disorders. This is a disease of the esophagus, the symptoms of which appear most often in women from 20 to 40 years old. They are most often stressed. The disease is also provoked by fatigue, chronic lack of sleep, and depression. Symptoms of neurosis include:

• burning in the chest;
• heartburn;
• heaviness in the esophagus;
• chest pressure;
• retention of food in it ( sensation).

How is this disease of the stomach and esophagus treated? Treatment is aimed primarily at eliminating the cause that caused the neurosis. At the same time, drugs with a mild sedative effect, vitamin complexes are prescribed. Problems with the esophagus (the symptoms are obviously varied) recede after the normalization of the psychological state. At the same time, all negative symptoms disappear.

scleroderma

Esophageal scleroderma is a progressive disease in which the connective tissues change. At the same time, sclerosis and atrophy of the mucosa of the organ develop. scleroderma most common in women. The provoking factors of the disease include:

• hypothermia;
• chronic infections;
• trauma;
• genetic factors;
• endocrine changes during menopause;
• intolerance to certain medications.

When this disease of the esophagus is present, symptoms (treatment will be determined) are most common in women between 20 and 50 years of age. The blood circulation in the hands and feet is disturbed. There are swelling of the skin, heartburn. The process of swallowing is very difficult. Treatment of scleroderma - long, for years, is carried out on an outpatient basis. Corticosteroids, vasodilating agents and improving blood microcirculation are prescribed.

Achalasia

Achalasia() refers to the neuromuscular group of diseases. This is a violation of the opening of the lower valve of the organ during the passage of food. The disease most often occurs in women between 20 and 40 years of age. Due to food delay, inflammation of the esophagus occurs, a cancerous tumor may develop.

The first sign and symptoms of esophageal disease in women is a violation of swallowing. It arises suddenly and gradually acquires a permanent form. Most often, this is preceded by nervous excitement.

Sometimes solid food passes well, but liquids are retained. After a violation of swallowing, symptoms of organ damage begin in the form of regurgitation, pain behind the sternum, and burning. This is accompanied by belching and nausea, there is increased salivation.

The method used to treat achalasia cardiomyotomy(dissection of the muscles of the problem valve). Medications are only auxiliary.

Surgical diseases of the esophagus

These include esophagoscopy, bougienage, sounding. The organ can be damaged by the endotracheal tube, during cardiodilation or surgery. Also in surgery, the pathology of the esophagus is a number of diseases with trauma to the organ - penetrating wounds, damage by solid food, burns, etc.

Useful video

Injury to the esophagus and diseases of the organ are unpleasant conditions that should be treated immediately by specialists. What complaints are most often treated by patients is described in this video.

Esophagitis

- an example of a disease of the esophagus and stomach, the symptoms of which are diverse. Pathology refers to inflammation of the mucosa. The contents of the stomach enter the esophageal tube. This is fraught with injury to the tissues of the lower section. It is painful for a person to swallow, flatulence begins.

With hemorrhagic disease of the esophagus and stomach, the symptoms are manifested in the form of vomiting with blood. With an exacerbation of the disease, the temperature rises, belching appears, strong salivation.

Chronic pathology of the esophagus is accompanied by inflammation of the mucosa. She becomes very sensitive. Erosion, suppuration appear on the organ. Inflammation of the mucosa can begin on psychological grounds. When the esophagus is injured, psychosomatics lies in depression, stress, emotional breakdowns.

In the treatment of an acute disease, a special diet, antibiotic therapy, painkillers are prescribed. Medicines of the famotidine group and antacids are prescribed. The patient must stop smoking. In chronic esophagitis, a sparing diet is prescribed with the exception of spicy, fatty, rough foods. Alcohol, smoking and certain medications are prohibited.

In addition to the listed symptoms of various diseases of the esophageal tube, problems with the vascular system are not uncommon. Often meets gastroesophageal disease, diffuse spasms, dyskinesia. Esophageal tuberculosis is very difficult to recognize. Atony appears with lesions of the central nervous system. When there is heaviness in the esophagus, its causes may not be associated with diseases. Such sensations are found in elementary overeating.

Benign tumors and cysts of the esophagus are rarely observed. Pathological picture. Tumors in relation to the wall of the esophagus can be intraluminal (polypoid) and intramural (intramural). Intraluminal tumors are located more often in the proximal or distal esophagus, intramural - in the lower two-thirds of it.

According to the histological structure, tumors are divided into epithelial (adenomatous polyps, papillomas) and non-epithelial (leiomyomas, rhabdomyomas, fibromas, lipomas, hemangiomas, neurinomas, chondromas, myxomas, etc.). The most common leiomyoma, which develops from smooth muscle fibers. The second most common place is occupied by cysts (retention, bronchogenic, enterogenic). Cysts are thin-walled formations containing a light viscous liquid. The wall of the cyst consists of fibrous tissue with an admixture of smooth muscle fibers and cartilage. The inner surface of the wall is lined with ciliated epithelium with a bronchogenic cyst and cylindrical or squamous - with an enterogenic one. Retention cysts are located in the submucosa of the esophagus and are formed as a result of blockage of the ducts of the glands. They never reach large sizes.

Clinical picture and diagnosis

Benign tumors and cysts of the esophagus grow slowly, do not cause clinical symptoms and are found incidentally on x-ray examination. The most common symptom is slowly increasing dysphagia over many years.

With intramural tumors, circularly covering the esophagus, dysphagia can be permanent, sometimes patients report pain, a feeling of pressure or fullness behind the sternum. With tumors of the cervical esophagus, which have a long stem, regurgitation of the tumor into the pharynx with the development of asphyxia may occur. Ulceration of the polyp or damage to the mucous membrane of the esophagus, stretched over a large intramural tumor, ulceration and bleeding are possible, cysts of the esophagus suppurate. Due to compression of the trachea, bronchi, heart, vagus nerves by the tumor, cough, shortness of breath, cyanosis, palpitations, pain in the heart, arrhythmia and other disorders may occur. Perhaps malignant degeneration of benign tumors and cysts of the esophagus.

The diagnosis of a benign tumor of the esophagus is made on the basis of an analysis of the clinical picture of the disease, X-ray data and esophagoscopy. For benign tumors of the esophagus, the following radiological signs are characteristic: clear, even contours of a filling defect located on one of the walls of the esophagus, the preservation of the relief of the mucous membrane and the elasticity of the walls in the area of ​​the defect, a clear angle between the wall of the esophagus and the edge of the tumor. All patients with benign diseases of the esophagus are shown esophagoscopy to clarify the nature of the formation, its localization and extent, the state of the mucous membrane. A biopsy can be performed only with the destruction of the mucous membrane and with intraluminal neoplasms.

Treatment of benign tumors and cysts of the esophagus

The main treatment for benign tumors is surgery. The purpose of the operation is to remove the tumor and prevent possible complications. Tumors of small size on a thin stem can be removed through an esophagoscope using special instruments or destroyed (electrocoagulation). Intraluminal tumors on a wide base are excised with a portion of the esophageal wall. Intramural tumors and cysts of the esophagus can almost always be enucleated without mucosal damage. Long-term results of operations are good.

A benign tumor of the esophagus is diagnosed more often in men aged 55–60 years. This is a fairly rare occurrence among all tumors of the gastrointestinal tract and is considered a congenital defect with an unclear etiology.

The disease is quite widespread and occupies the 6th place among cancerous tumors. The development of a neoplasm is possible in any of the sections of the gastric tract, and treatment justifies itself only at the initial stage of the disease with the appearance of primary suspicious symptoms: excessive weight loss and the inability to swallow even soft food.

The tumor requires surgical removal, regardless of stage. According to the types and form of growth, there are:

• intraluminal cancer;
• adenoma;
• papilloma;
• lipoma;
• fibroma.

To identify a tumor in the esophagus at the initial stage is possible only through endoscopy. And in most cases, it is benign in nature, but when it grows in the trachea, bronchi, any part of the sternum, other distant organs, it can degenerate into a malignant one.

Esophageal tumor classification

The classification of tumors of the esophagus is represented by 2 large groups: benign and malignant.

A benign tumor in nature, growth and etiological structure develops in the form of adenoma, papilloma, lipoma, angioma, myoma, chondroma, myxoma. The most common non-epithelial type of tumor. According to the shape and growth inside the walls, there is a development of a translucent intramural form.

Malignant tumors of the esophagus, taking into account histology, depend on the structure, location and morphology. There are the following types of cancer: melanoma, squamous non-keratinized, transitional cell or mucoepidermoid. With this in mind, oncologists determine the treatment tactics during further observation of the patient.

Depending on the characteristics of growth and the degree of involvement of the esophagus, the following types are distinguished:

• endogenous - with localization in the submucosal layer of the esophagus;
• exophytic - when formed in the lumen of the esophagus, just above the mucous layer;
• mixed - when the walls of the esophagus are formed in any layers, followed by manifestation, decay, necrosis of the walls of the esophagus, the appearance of ulcerative areas at the sites of lesions.

In the initial stages, benign tumors of the esophagus are successfully treated. Oncologists give quite encouraging forecasts, survival within 5 years in 80-90% of cases. At the 4th stage of cancer, with the spread of metastases, the tumor is already difficult to treat even with the latest methods in oncology.

Benign tumors of the esophagus are more of a congenital origin with growth in the form of an epithelial or non-epithelial cyst. In form - in the form of an intraluminal adenoma, fibroma, lipoma, papilloma, leading to narrowing of the lumen in the larynx, asphyxia, suffocation and sudden death.

With the localization of the tumor inside the walls in the lower part of the esophagus, the symptoms may not manifest themselves for a long time. Only with excessive squeezing of the walls, which leads to blockage of the esophageal lumen, symptoms can manifest as:

• obstruction of food;
• pain in the sternum;
• nausea, gag reflex;
• loss of appetite;
• difficulty in swallowing;
• shortness of breath;
• cough
• hoarseness of voice;

In advanced cases, fibroids develop when the tumor reaches a gigantic size up to 18 cm in length, but it is asymptomatic and only as it develops leads to decay, internal bleeding, and covering of the mucous membrane with erosions.

With the localization of the formation in the lower part of the esophagus, the development of a cyst is possible, as a benign formation, often congenital, with a cavity filled with a yellowish serous-purulent fluid. The structure of the mucosa eventually acquires a hemorrhagic shade, the tumor rapidly increases in size. When the secretion of gastric juice is activated, the esophagus is compressed in the mediastinum, and then more pronounced clinical symptoms begin to appear, and treatment becomes already difficult. In the event of profuse bleeding, the tumor transforms into a malignant form, suppuration with the addition of anaerobic microbial flora, and further spread of metastases.

Primary signs of the disease

The primary initial stage of cancer practically does not manifest itself. Symptoms are absent even at 2-3 stages of pathology. Often, the tumor is detected by chance, when dysphagia of the esophagus is already obvious, difficulty in swallowing even liquid food against the background of the development of an inflammatory process in the throat. Problems of the gastrointestinal tract begin, the passage of food becomes difficult, it hurts behind the sternum, weakness and fatigue appear.

Such symptoms should be the reason for going to the doctors, this already speaks of disorders in the body and the need for diagnostics.

Benign tumors of the esophagus are quite rare and occur in only 1% of cases. Most often, leiomyoma develops in the form of an epithelial glandular polyp, adenoma, hemangioma, chondroma, myxoma. A benign tumor can be detected in any part of the esophagus, more often as a single pedunculated polyp with a smooth or tuberous structure. Depending on the type and clinical features, the polyp can also grow in multiple forms, leading to:

• dysfunction of swallowing;
• sore throat;
• problems with taking even liquid food;
• a sense of presence;
• nausea and vomiting;
• increased salivation;
• mild pain in the sternum, with an increase in meals;
• weakness, dizziness, fatigue in case of internal bleeding;
• the appearance of ulcers;
• weight loss for no reason;
• signs of anemia on the background of iron deficiency in case of internal bleeding.

Often, a tumor is detected only with an accidental x-ray of the peritoneal organs.

What complications can it lead to?

If the disease is not treated in a timely manner, then a large tumor will eventually lead to complete blockage and obstruction of the esophageal canal, the inability to swallow even the most liquid food, hemorrhage against the background of decay, bleeding and thinning of the walls of the esophagus.

The patient begins to refuse food, against the background of the collapse of the tumor, there is a paroxysmal cough, perforation of the trachea, fistulas in the esophageal region with further spread to the blood vessels and parts of the mediastinum.

The condition worsens greatly when metastases spread to the area above the collarbone, liver, bone structures, lungs, brain, upper neck.

In order to diagnose and clarify the diagnosis, CT, MRI, ultrasound, esophagogastroduodenoscopy are required to view the esophageal mucosa, identify the type, shape and size of the tumor. X-ray is performed with the introduction of a contrast agent to identify irregularities that indicate the localization of the tumor and the degree of patency in the esophagus.

Treatment of the disease

Treatment must be carried out necessarily when the most primary unpleasant symptoms appear, deterioration of swallowing functions. If you suspect a benign tumor of the esophagus, you should not hesitate to contact a surgeon or gastroenterologist for advice. If the disease is not treated at the initial stage, then complications, deterioration of health and death are inevitable.

If an intraluminal tumor on the stalk is detected, electroexcision is prescribed, with an intrasystemic tumor - thoracotomy with the possibility of restoring the integrity of the muscular membrane of the esophagus in the future.

The main treatment for esophageal cancer is surgery. The main thing is not to harm the mucous membrane, to avoid the development of a purulent process. If the tumor has reached a large size and has led to partial destruction of the muscular membrane of the esophagus, then it is possible to carry out measures for resection of the esophagus. Surgical intervention and radiation therapy remain the best methods of influencing the tumor today, allowing to achieve an effect in 40% of cases. Chemotherapy is prescribed only when a low-cell or differentiated form of cancer is detected.

Surgical treatment is carried out with the introduction of an endoscope in order to remove the tumor. After the operation, patients will have to go through a long rehabilitation period to restore damaged tissues of the esophageal mucosa.

A special diet No. 1, 5, 16 and proton pump inhibitors are prescribed. Benign tumors are well treated with folk herbs, beta-blockers of the proton pump in order to reduce the production of hydrochloric acid in the stomach.

Alternative treatment

Alternative methods of treatment do not guarantee a 100% cure for malignant neoplasms, so you should not rely only on them. All folk remedies should be used only in addition to medical treatment.

Many recipes of traditional medicine have been known to people for hundreds of years. The main methods of folk cancer treatment are tinctures, herbs, infusions of herbs and mushrooms. The composition of some herbs and fruits really includes substances that stop and inhibit the growth of malignant tumors and, in particular, cancerous neoplasms of the esophagus.

For treatment with folk remedies, you need to contact a phytotherapeutist who will advise you on how to properly prepare and take a decoction.

Prognosis for esophageal cancer

Treatment of cancer of the esophagus in full is no longer possible. The sooner and earlier seek help from doctors, the greater the chances of success and complete suppression of the tumor with minimization of consequences and relapse in the future.

The insidiousness of esophageal cancer is in the absence of symptoms. Patients often turn to specialists when the process is already too advanced, and even a surgical operation does not guarantee the complete eradication of the tumor. If the disease is not treated, then death can occur suddenly in the first 6–7 months, although it can take up to 7 years from the onset of tumor development.

In advanced cases, with a strong growth of the tumor and metastasis to other neighboring organs, it becomes pointless to carry out the operation. At stages 3-4 of cancer, doctors often decide to conduct radiation and chemotherapy, but already guarantee a 5-year survival rate for 15% of patients. Although modern techniques and developed treatment today can significantly increase these survival rates. A benign tumor has a quite favorable outcome if removed in a timely manner, and rarely leads to relapses and disability of the esophagus.

Neoplasm is a pathological process, as a result of which new tissues are formed with changes in the genetic apparatus of cells, which entails a failure in the regulation of their differentiation and growth. Neoplasms are called tumors and are divided into benign and malignant. Tumors of the esophagus have pronounced symptoms, observing which, the patient should consult a doctor who will diagnose and prescribe treatment.

Pathologies in the esophagus with the formation of new tissues may portend cancer.

Symptoms

The formation that arose in the patient recently is small, which means that the disease does not manifest itself. With the growth of tumors, various symptoms are observed. Thus, in the first stages of the tumor of the esophagus are accompanied by the following symptoms:

• loss of appetite;
• there is a sharp decrease in body weight;
• feeling weak;
• there is constant fatigue.

Symptoms, at first glance, do not indicate the occurrence of a serious change in the body and the patient does not attach importance and is in no hurry to consult a doctor, but with the development of a tumor, it acquires other signs of the disease:

• the process of swallowing food becomes more difficult due to the narrowing of the esophagus;
• there is nausea, vomiting, bad breath;
• there are pains in the chest area, which occur due to pinched nerve endings;
• tumors are accompanied by shortness of breath, cough, pain in the chest, a hoarse voice and a rise in body temperature.

Diagnostic methods

Diagnostics will allow the doctor to determine the location and size of the newly formed tissue, to find out whether it is malignant or benign. Benign tumors of the esophagus are diagnosed using x-rays and esophagoscopy. Malignant tumors of the esophagus are diagnosed by X-ray and endoscopic methods, to which there is an addition in the form of a morphological study of samples of changing sections of the esophageal mucosa.

An x-ray examines the functionality of swallowing and determines the location of the violation (in the esophagus or in the pharynx). If the x-ray diagnosed a malfunction in the functionality of the esophagus, then the next steps will be to identify irritating food. With the help of x-rays, you can find out about the location of the tumor, its size and the general condition of the affected organ.

In the esophagus, new altered tissues can be diagnosed by the endoscopic method, which is most popular in the early stages of the disease, when symptoms are hardly noticeable. This diagnostic method is based on a visual examination, in the sampling of a part of the esophageal mucosa for other necessary studies. Tumors can be diagnosed using ultrasound, using computed tomography.

Kinds

Before treatment can begin for esophageal masses, it is important to properly diagnose them. Thus, the classification of tumors is as follows:

• according to the location they distinguish: below, in the middle and at the top of the organ;
• by structure: originates from glands produced by mucus and from squamous epithelial cells.

Tumors of the esophagus are divided into benign and malignant. Benign ones do not pose a threat to human life, provided they are removed in a timely manner, if such new altered tissues are left unnoticed, they will take on a malignant form. Malignant tumors are characterized by the growth of metastases and pose a threat to human life.

benign

A benign tumor of the esophagus is a neoplasm that is formed from various layers of the walls of the stomach and is characterized by slow development without genetic changes in cells. Thus, a benign formation has a localization of mucous, submucosal, subserous and muscular. The classification of benign pathological tissue growths is as follows:

• endogastric;
• intramural;
• exogastric.

Benign tumors of the esophagus are of the following types:

• Leiomyoma. It occurs among other benign formations of the esophagus most often and comes out of its muscular membrane. In rare cases, it is formed from its muscular mucosa. Leiomyomas are localized in the thoracic and cervical parts of the organ and measure from five to eight centimeters. Leiomyoma occurs in males whose age ranges from 20 to 50 years.
• Esophageal cyst. The cyst often spreads in the lower part of the organ and has a congenital character. It has the appearance of a thin-walled formation and contains a clear liquid with a yellow tint.
• xanthoma. Gastric xanthoma occurs as a result of the deposition of fats in the mucous membrane. It is observed in elderly people with atherosclerosis in the vessels, in patients with atrophic gastritis and diabetes mellitus. The xanthoma of the stomach has dimensions from a millimeter to one and a half centimeters and is distinguished by yellow or white-yellow color.
• Abrikosov's tumor or granular cell myoblastoma. Myoblastomyoma Abrikosov has sizes from a centimeter to four. Localized in the submucosal layer of the bronchi and trachea, has rounded large cells and fuzzy contours and fine-grained cytoplasm. Abrikosov's myoblastomyoma in every second patient is removed by endoscopy and in 50% of cases requires repeated surgical intervention.

Malignant

Malignant neoplasms are tumors that have completely or partially lost the ability to differentiate. Malignant tumors are often observed in people over 60 years of age. Symptoms of malignant neoplasms of the esophagus are as follows:

At the late stage of the disease, there is general weakness, poor appetite, fatigue, dry mouth, dry eyes and nose, sleep disturbances, increased sweating. In addition to these symptoms, the patient's body temperature rises, anemia is diagnosed, immunity decreases and nausea with vomiting appears.

Malignant tumors are of four types: lymphoma, carcinoma, cancer of the esophagus and leiomyosarcoma, have four stages, the last of which is characterized by a tumor of various sizes and the growth of any nature of individual metastases. Doctors cannot name the leading cause of the occurrence of malignant tumors, they only highlight contributing factors. These include:

• anemia;
• narrowing of the esophagus;
• malnutrition;
• gastroesophageal reflux;
• excessive alcohol consumption;
• hernia;
• hereditary malignancies.

Treatment

Methods of therapy for malignant and benign neoplasms are selected for each patient individually. Treatment of a tumor-like area is of the following types:

• surgical removal of a separate area with a tumor;
• intubation, which is based on the introduction of a special tube into the esophagus, which can improve swallowing and increase narrowing;
• radiotherapy is necessary if there is a tumor on the outside of the organ;
• laser therapy is used if it is necessary to remove the neoplasm in several cycles;
• chemotherapy can shrink the tumor-like area and has the ability to stop the development of cancer.

- histologically heterogeneous epithelial and non-epithelial neoplasms of the esophageal wall with intraluminal or intramural growth. Benign tumors of the esophagus are manifested by symptoms of dysphagia, chest pain, nausea, regurgitation, and weight loss. Diagnosis of tumors is based on contrast radiography of the esophagus, esophagoscopy, endoscopic biopsy, CT, histological examination of the biopsy. Treatment of benign tumors of the esophagus consists in their removal by endoscopy or abdominal intervention (enucleation of the tumor, resection of the esophagus).

Benign tumors of the esophagus are relatively rare findings in gastroenterology, accounting for 0.5 to 5% of all esophageal neoplasms. Most often tumors of the esophagus develop in men; the predominant age of patients is from 25 to 60 years. The etiology of benign esophageal tumors is unknown; the exception is esophageal cysts, which are embryonic malformations. Favorite places of localization of tumors are natural constrictions and the lower third of the esophagus.

Classification of benign tumors of the esophagus

According to the histological structure, epithelial and non-epithelial benign tumors of the esophagus are distinguished. Neoplasms of the epithelial type include papillomas, adenomas and cysts of the esophagus (retention, enterogenic, bronchogenic, reduplication, cystic esophagitis, etc.). Non-epithelial tumors include fibromas, leiomyomas, lipomas, capillary and cavernous hemangiomas, lymphangiomas, neurofibromas, neurinomas, osteochondromas, teratomas, myxomas, and other rare forms.

According to the way of growth, benign tumors of the esophagus can be intraluminal (polypoid) and intramural (intramural). Papillomas, adenomas, polyps belong to intraluminal tumors; to intramural - cysts, leiomyomas, etc. Other types of benign tumors of the esophagus are quite rare.

Characteristics of benign tumors of the esophagus

Adenomas and polyps can be located anywhere in the esophagus; most often they are found in the cervical or abdominal region. These tumors can grow on a broad base or a long stalk; in the latter case, their prolapse from the esophagus into the pharynx or infringement in the cardiac region is not excluded, which is accompanied by appropriate symptoms. In endoscopic examination, adenomas and polyps are defined as reddish neoplasms, clearly delimited from the walls of the esophagus, sometimes with a lobed structure. Due to the superficial location of the vessels, the tumors bleed easily on contact.

Esophageal cysts are not true tumors; their formation is associated with blockage of the mucous glands in violation of embryogenesis. Most often, cysts form in the lower third of the esophagus. They are thin-walled formations filled with a clear, opalescent, yellowish or hemorrhagic fluid. The contents of the cyst can be mucous, serous, jelly-like, serous-purulent. The walls of the cyst are formed from the outside by smooth muscle or fibrous tissue, from the inside they are lined with squamous, ciliated or cylindrical epithelium. Cysts can ulcerate, become infected with microbial flora, and sometimes become malignant.

Among non-epithelial formations of the esophagus, the majority (70-95%) are leiomyomas originating from the smooth muscle layer of the esophagus or from the muscular elements of its mucosa. Usually leiomyomas grow in the form of a single node and have polycyclic contours; less often formed by several nodes interconnected. Leiomyomas develop in the thickness of the muscular layer of the esophagus, leading to stretching and thinning of the walls.

In 90% of cases, leiomyomas are formed in the thoracic esophagus, in 7% of cases - in the cervical part. Prolapse of the tumor into the lumen of the esophagus causes its narrowing and dysphagia. Microscopically, leiomyoma is formed by bundles of smooth muscle fibers that alternate with fibrous connective tissue areas. With the predominance of connective tissue in the structure of the tumor, the neoplasm is regarded as a fibromyoma.

Among rare forms of benign tumors of the esophagus there are fibromas, lipomas, neurinomas, lymphangiomas, hemangiomas. Neurinomas and fibromas have a denser consistency; closely soldered to the esophageal wall, originate from nerve structures or paraesophageal tissue, may have a mixed structure - neurofibromas.

Vascular (lymphangiomas, hemangiomas) and fatty tumors (lipomas), as a rule, of a soft consistency, do not always have clear boundaries, can spread along the wall of the esophagus and into the surrounding tissues.

Symptoms of benign tumors of the esophagus

The specificity of the manifestations of benign tumors of the esophagus is due to the type of their growth, localization and size; to a lesser extent, the symptoms are affected by the histological structure.

Tumors growing in the lumen of the esophagus cause dysphagia - a violation of the passage of food masses through the esophagus: difficulty in swallowing solid food, feeling of a lump behind the sternum. The severity of dysphagia increases as the tumor grows. Often, with intraluminal tumors of the esophagus, moderate pain behind the sternum of a dull or spastic nature, a feeling of discomfort in the throat or chest, which increase at the time of eating, are noted.

Symptoms of benign tumors of the esophagus may include salivation, nausea, belching, and regurgitation. Intraluminal tumors of large size often cause vomiting, as a result of which patients rapidly lose weight. Intraluminal tumors are often injured by food, ulcerate, which is accompanied by bleeding from the esophagus, anemia. Complete obstruction of the esophagus by a benign tumor, as a rule, is not observed. Occasionally, intraluminal tumors on a long stalk migrate into the lumen of the larynx during vomiting, leading to asphyxia, sometimes with a fatal outcome.

Tumors with intraparietal growth are more often located in the distal part of the esophagus and develop asymptomatically for a long time. Neoplasms that have reached a significant size cause dysphagia, nausea, retrosternal pain of moderate intensity, loss of appetite. In the case of extraesophageal tumor growth, a compression syndrome may develop, caused by compression of the mediastinal organs (vagus nerve, bronchi, large veins). In this case, there is hoarseness of voice, increased pain behind the sternum, the appearance of a dry cough, tachycardia, arrhythmia. With cysts of the esophagus, their suppuration and perforation can occur.

In rare cases, malignancy of benign tumors with the development of esophageal cancer is possible.

Diagnosis of benign tumors of the esophagus

In the diagnosis of benign tumors of the esophagus, the leading role belongs to X-ray and endoscopic research methods.

Contrast radiography of the esophagus allows you to detect a tumor formation, find out its localization, the severity of the narrowing of the lumen of the esophagus and deformation of its walls. The X-ray picture in intramural tumors is characterized by the detection of a sharply defined filling defect, displacement of the lumen of the esophagus, suprastenotic expansion of the esophagus, smoothing of the folds of the esophageal wall at the site of the tumor. With intraluminal tumors, a filling defect with smooth, clear contours is determined, “streamlined” by a contrast suspension and displaced along with the esophageal wall. The peristalsis of the walls of the esophagus at the location of the tumor is preserved.

Esophagoscopy (esophagogastroscopy) is necessary to determine the type of growth and the nature of the formation, its size and localization. For better visualization of changes in the esophageal walls, chromoscopy of the esophagus is performed. With intraluminal tumors during esophagoscopy, an endoscopic biopsy is performed, which allows for subsequent cytological and morphological examination of tumor tissues. With intramural tumor growth, a biopsy is contraindicated due to the deep location of the neoplasm in the wall of the esophagus, the risk of injury and infection of the mucous membrane.

With extraesophageal growth of the neoplasm and its interaction with the mediastinal organs, they resort to chest x-ray and pneumomediastinography. In doubtful cases, CT and MRI of the mediastinum are used.

Treatment of benign tumors of the esophagus

Due to the fact that tumors of the esophagus are often complicated by ulceration, bleeding, suppuration, malignancy, surgical tactics are indicated for them. Epithelial intraluminal tumors that have a long, narrow stalk can be removed by electroexcision through an endoscope. It is more expedient to excise tumors on a wide base in the process of open esophagotomy. Resection of the esophagus is resorted to in cases where malignancy cannot be ruled out, or with a significant size of the tumor.

Intramural tumors of the esophagus require thoracotomy, enucleation of the tumor, and subsequent restoration of the integrity of the esophageal wall. With a significant destruction of the muscle wall, a part of the esophagus is resected with its plasty with a gastric, small intestine or large intestine graft or esophagogastroanastomosis is applied.

Prognosis for benign tumors of the esophagus

The postoperative prognosis is usually favorable. Relapses of the disease are rare; in almost all cases, the function of the esophagus is restored completely, the ability to work is preserved. After surgery, dynamic monitoring by a gastroenterologist is indicated.

If the operation is refused, a complicated variant of the development of benign tumors of the esophagus is possible, up to their malignant degeneration.

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