Leiomyoma in the Esophagogastric Junction Removed by Enucleation

Kim, Wan Su; Kweon, Tae Hun; Park, Jin Hong; Yun, Seol Yeong; Jung, Mi Hyee; Choi, Seong Ho

Abstract

Although an esophageal leiomyoma is one of the most common benign tumors of the esophagus, i is still rare. It occurs more often in men than in women, by a ratio of 1.9 to 1. About 97 percen of the esophageal leiomyoma may occur as intramural type and only 1% of the tumor may be polypoid type. Over 50% of the patients with a leiomyoma of the esophagus are asymptomatic, bu dysphagia and vague pain are the most frequent symptoms. Differential diagnosis is often difficult because an esophageal leiomyoma may mimic mediastinal neoplasms, cysts, aortic aneurysms, and esophageal diverticulum. Operative management by transthoracic enucleation is the procedure of choice, although resection of the esophagus may be required in few cases. Its result is excellent and postoperative morbidity is low. We experienced a case of a 24-year-old man with esophagea leiomyoma in the esophagogastric junction. The patient complained of substernal discomfort and dysphagia for about a year. The upper gastrointestinal endoscopy disclosed an elongated, submucosa mass lesion with central ulceration, ranging from the distal esophagus to the cardia of the stomach The size was 7 x 4 x 2 cm. The mass was removed by the transabdominal enucleation. The diagnosis of leiomyoma was confirmed with histopathologic finding.