Oesophageal lipoma

Oesophageal lipomas are rare fat containing intrathoracic lesion.

They may account for approximately 0.4% of the benign tumours of the alimentary tract 1. There may be greater male predilection. The average age of presentation at around 50 years. 

As with all lipomas, they are composed off entirely of mature adipocytes with or without mesenchymal tissue elements. There exists a variety of histological subtypes which include spindle cell lipoma, angiolipoma, myolipoma, fibrolipoma, myxoid lipoma, and the common classic lipoma. Some lesions may be pedunculated.

Location

In terms of location, they most commonly occur in the upper one-third of the oesophagus but can potentially occur anywhere from the pharynx to the distal oesophagus. 

They are usually small, asymptomatic and incidentally detected. When large (>3 cm), patients may present with symptoms such as dysphagia, regurgitation, epigastralgia or haemorrhage which would warrant surgical excision.

Fluoroscopy (Barium swallow)

They can appear as smooth intraluminal filling defects. Some may be peduculated. 

CT

CT characteristically demonstrates a homogeneous fat attenuation in typical lesions.

MRI

Follows fat signal with high T1 weighted intensity that becomes low intensity of fat-suppressed images.

Possible differential considerations include

For atypical lesions consider other oesophageal lesions such as 

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Article Information

rID: 49800
System: Chest
Synonyms or Alternate Spellings:
  • Oesophageal lipomas
  • Oesophageal lipomata
  • Lipoma of oesophagus
  • Lipoma of esophagus
  • Esophageal lipoma
  • Esophageal lipomas
  • Esophageal lipomata

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