Acute esophageal hemorrhage from a vagal neurilemoma.
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.
DeVault
K R
KR
Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.
Miller
L S
LS
Yaghsezian
H
H
Spirig
A M
AM
Dhuria
M
M
Armenti
F R
FR
Connell
D C
DC
Martin
P
P
Castell
D O
DO
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