title: Acute esophageal hemorrhage from a vagal neurilemoma.
abstract: A man with known systemic neurofibromatosis developed an acute upper gastrointestinal hemorrhage while hospitalized after a neurosurgical procedure. Endoscopic evaluation showed a vascular lesion with an appearance consistent with a Dieulafoy-type lesion in the distal esophagus. Despite multiple endoscopic procedures with attempted coagulation of the bleeding lesion, the patient continued to have life-threatening hemorrhaging. At thoractomy, a tumor was found to arise from the vagus nerve at the site of bleeding. This tumor was resected and histologically determined to be a neurilemoma. Acute bleeding into the esophagus associated with this type of tumor has not been previously reported.
authors.affiliation: Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.
authors.forename: K R
authors.initials: KR
authors.lastname: DeVault
authors.forename: L S
authors.initials: LS
authors.lastname: Miller
authors.forename: H
authors.initials: H
authors.lastname: Yaghsezian
authors.forename: A M
authors.initials: AM
authors.lastname: Spirig
authors.forename: M
authors.initials: M
authors.lastname: Dhuria
authors.forename: F R
authors.initials: FR
authors.lastname: Armenti
authors.forename: D C
authors.initials: DC
authors.lastname: Connell
authors.forename: P
authors.initials: P
authors.lastname: Martin
authors.forename: D O
authors.initials: DO
authors.lastname: Castell
mesh_terms: D003390:Cranial Nerve Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D004724:Endoscopy; D004935:Esophageal Diseases / Q000209:etiology* / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D009455:Neurofibroma / Q000150:complications / Q000175:diagnosis; D013908:Thoracotomy; D014630:Vagus Nerve