Lymphangioma of the cervical esophagus associated with an inlet patch

Lymphangiomas of the esophagus are extremely rare benign tumors of lymphatic origin. Localization in the proximal esophagus in association with an inlet patch and treatment by minimally invasive esophagectomy have not been reported.

A 74-year-old woman with a 12-year history of multiple endoscopic dilatations was referred because of progressive dysphagia and aspiration. A 1.5-cm stricture of the cervical esophagus with a residual diameter of 5 mm was confirmed at endoscopy. Biopsies were negative for dysplasia/neoplasia.

Laparoscopic transhiatal esophagectomy with cervical esophagogastric anastomosis was successfully performed. Pathological examination of the surgical specimen demonstrated the presence of a lymphangioma. Interestingly, heterotopic gastric mucosa was present in the epithelium overlying the lymphangioma.

Dysphagia was successfully relieved with a minimally invasive esophagectomy and lymphangioma of the cervical esophagus was found to be the cause of obstruction and aspiration in this patient, who was a non-responder to endoscopic dilatation. The inlet patch was an incidental finding unrelated to symptoms.