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World Journal of Surgery

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Open Access 01-01-2021 | Endoscopy | Scientific Review

Esophageal Lipoma and Liposarcoma: A Systematic Review

Authors: Davide Ferrari, Daniele Bernardi, Stefano Siboni, Veronica Lazzari, Emanuele Asti, Luigi Bonavina

Published in: World Journal of Surgery | Issue 1/2021

Abstract

Background

Esophageal lipomatous tumors, also reported as fibrovascular polyp, fibrolipoma, angiolipoma, and liposarcoma, account for less than 1% of all benign mesenchymal submucosal tumors of the esophagus. Clinical presentation and therapy may differ based on location, size, and morphology. A comprehensive and updated systematic review of the literature is lacking.

Methods

A systematic review of the literature was performed according to PRISMA guidelines. Pubmed, Embase, Cochrane, and Medline databases were consulted using MESH keywords. Non-English written articles and abstracts were excluded. Sex, age, symptoms at presentation, diagnosis, tumor location and size, surgical approach and technique of excision, pathology, and morphology were extracted and recorded in an electronic database.

Results

Sixty-seven studies for a total of 239 patients with esophageal lipoma or liposarcoma were included in the qualitative analysis. Among 176 patients with benign lipoma, the median age was 55. The main symptoms were dysphagia (64.2%), transoral polyp regurgitation (32.4%), and globus sensation (22.7%). The majority of lipomas (85.7%) were intraluminal polyps, with a stalk originating from the upper esophagus. Overall, 165 patients underwent excision of the mass through open surgery (65.5%), endoscopy (27.9%), or laparoscopy/thoracoscopy (3.6%). Only 5 (3%) of patients required esophagectomy. Of the 11 untreated patients with an intraluminal polyp, 7 died from asphyxia. Overall, liposarcoma was diagnosed in 63 patients, and 12 (19%) underwent esophagectomy.

Conclusion

Esophageal lipomatous tumors are rare but potentially lethal when are intraluminal and originate from the cervical esophagus. Modern radiological imaging has improved diagnostic accuracy. Minimally invasive transoral and laparoscopic/thoracoscopic techniques represent the therapeutic approach of choice.

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Title: Esophageal Lipoma and Liposarcoma: A Systematic Review
Authors: Davide Ferrari
Daniele Bernardi
Stefano Siboni
Veronica Lazzari
Emanuele Asti
Luigi Bonavina
Publication date: 01-01-2021
Publisher: Springer International Publishing
Keywords: Endoscopy
Lipoma
Lipoma
Liposarcoma
Esophagus Resection
Thoracoscopy
Esophagus Resection
Published in: World Journal of Surgery / Issue 1/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05789-4

At a glance: The STEP trials

Springer Medicine

Esophageal Lipoma and Liposarcoma: A Systematic Review

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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