Esophageal lipoma

Last revised by Yahya Baba on 19 Jan 2021

Esophageal lipomas (or lipomata) are rare fat-containing esophageal lesions.

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

They are usually small, asymptomatic and incidentally detected. When large (>3 cm), patients may present with symptoms such as dysphagia, regurgitation, odynophagia, epigastralgia or hemorrhage.

As with all lipomas, they are composed 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.

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

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

CT characteristically demonstrates a homogeneous fat attenuation in typical lesions.

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

Possible differential considerations include

For atypical lesions consider other esophageal lesions such as

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Cases and figures

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