Giant leiomyoma of the oesophagus

Giant leiomyoma of esophagus

This case report of a 37-year-old man with giant leiomyoma details some of the problems encountered in diagnosing and treating this rare form of the disease. Initial studies at another institution were interpreted as demonstrating achalasia, and thoracotomy was later undertaken because of a mistaken diagnosis of a pericardiac mass, which led to a biopsy and a resulting esophagopleural fistula. Subsequent esophagectomy and drainage of empyema space were employed to remove the tumor, which had ulcerated and bled, as well as to drain the empyema cavity. The tumor measured 20.5 cm long and weighed 540 gm. Gastrointestinal continuity was reestablished by colon interposition, and the patient has been well for the succeeding 6 years.

Leiomyomata of the esophagus. An analysis of 838 cases

Review of the world literature to the end of 1971 has provided data on 838 cases of esophageal leiomyomata, including our own 19 surgically removed lesions. Although esophageal leiomyoma is the most common of the benign tumors of the esophagus, it is still rare compared with carcinoma. It occurs in more men than women, by a ratio of 1.9 to 1. Over 50% of the patients with leiomyoma of the esophagus are asymptomatic. Dysphagia and vague pain are the most frequent symptoms. Pyrosis is mentioned in the literature as present in 40% of the cases, but it is considered mainly as symptom of coexistent hiatal hernia. Diagnostic problems often arise, as the smooth muscle tumors may mimic mediastinal neoplasms, cysts, or even aneurysms, or complicate coexisting hiatal hernia and esophageal diverticulum. Operative management by transthoracic enucleation is the procedure of choice, although resection of the esophagaus may be required in few cases. Postoperative morbidity is minimal and results are excellent.

Unusual presentation of a large leiomyoma of the esophagus

A case is presented with a giant pedunculated leiomyoma of the esophagus. The difficulties of diagnosis are presented along with a review of the literature. Surgical removal is safe and curative.