Tumours

Benign tumours of the oesophagus Benign tumours of the oesophagus are rare. They only cause local complaints and do not metastasize. Treatment is only necessary when there are complaints, or when there is a chance that the benign tumour transforms into a malign tumour. Beneath you will find an overview of the benign tumours of the oesophagus. Click on the links for more information.

Barrett’s oesophagus

Barrett’s oesophagus develops mostly in the lower part of the oesophagus. It is caused by years of acid regurgitation from the intestines and stomach into the oesophagus. It can lead to complaints, but not necessarily. The regurgitating intestinal and stomach contents irritate the mucosal layer, and might induce a change from normal mucosa to ‘Barrett” mucosa. This mucosa is similar to that of the stomach and as such it is more resistant to regurgitating stomach contents. However, patients with Barrett’s mucosa have a higher risk for developing oesophageal cancer. Patients with complaints of regurgitation, heartburn, are treated with pills that lower the amount of acid in the stomach. However, these pills do not protect against the effects of the regurgitating intestinal contents.

Leiomyoma

Tissue from a leiomyoma as seen with a microscope

Tissue from a leiomyoma as seen with a microscope

Leiomyoma are rare, benign tumours that growth from the connective tissue from the oesophagus. Mostly they are found in a late stage, when the tumour has grown large and obstructs the passage of food. Sometimes they are found by chance, when a gastroscopy or CT-scan is performed for other complaints. It is important to differentiate this tumour from the malign variant; leiomyosarcoma. The best way to do this is through an internal ultrasonography. The treatment consists of a minimally invasive operation through the chest during which the tumour is enucleated. When it is unclear if it concerns a leiomyoma or a leiomyosarcoma, the best strategy is to remove the whole oesophagus. The oesophagus is replaced by a tube made from the stomach.

Malignant tumours of the oesophagus Malignant is a synonym for cancer. Oesophageal cancer is often discovered late because complaints are caused late in the course of this disease. The most tumours originate from the mucosal layer of the oesophagus. The tumours that originate from the muscular layer are rare. The most common type in the Netherlands are the tumours that originate on the border of oesophagus and stomach, caused by years of irritation by stomach and intestinal contents. You will find information about the different types of oesophageal cancer here.

Beneath you will find an overview of the benign tumours of the oesophagus.

Oesophageal cancer: Adenocarcinoma

Tissue from an adenocarcinoma as seen with a microscope

Tissue from an adenocarcinoma as seen with a microscope

Adenocarcinoma mostly develops in the lower part of the oesophagus. The reason is that in many cases (but not all!) regurgitation of stomach and intestinal contents irritated the mucosal layer of the lower oesophagus. This can induce a change from oesophageal mucosa into Barrett’s mucosa. This mucosa is similar to stomach mucosa, and therefore more resistant to irritation by gastric and intestinal contents. Patients with a Barrett’s oesophagus have an increased chance for developing oesophageal cancer.

Oesophageal cancer: Squamous cell carcinoma

Tissue from a squamous cell carcinoma as seen with a microscope

Tissue from a squamous cell carcinoma as seen with a microscope

Squamous cell carcinoma mostly develops in the upper part of the oesophagus. It is often (but not always!) result of years of smoking, years of drinking too much alcohol, or a combination of these two factors.

GIST

Gastrointestinal stromacell tumours (GIST) are rare tumours that originate from the connective tissue from the oesophagus. Mostly they are found in a late stage, when the tumour has grown large and obstructs the passage of food. Sometimes they are found by chance, when a gastroscopy or CT-scan is performed for other complaints. The level of aggressiveness determines the chance of distant metastasis. The treatment consists of an operation during which the oesophagus is removed. A tube is made from the stomach that will replace the oesophagus. There exists an effective medicine (Glivec) that can be used to treat metastases or reduce the tumour volume before the operation (neoadjuvant therapy).

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