Background: It's hard for conventional endoscopy to make a distinction between esophageal leiomyoma and submucosal lesions. The clinical features of elder patients with esophageal leiomyoma may be different with non-elder ones. This study examined the clinical value of endoscopic ultrasonography (EUS) in patients with esophageal leiomyoma, conclude the clinical characteristics of them, especially elder ones.Methods: During 2005-2015, 2,134 patients were diagnosed with esophageal leiomyoma by EUS, there are 249 elder patients (65 years and older) and 1,885 non-elder patients (under 65 years). We analyzed the clinical features, auxiliary examinations features, treatment outcomes and follow-up results of these patients, especially elder ones.Results: EUS were well tolerable in elder and non-elder patients. There was no difference in number, location, origin, size of lesions and in symptoms related esophageal leiomyoma between two groups. Elder patients had more positive changes in serological examinations. Preoperative diagnostic accuracy of EUS for esophageal leiomyoma was obviously superior to conventional endoscopy and computed tomography (CT).The misdiagnosis rate of malignant tumors was higher in elder ones. Fewer elder patients chose to be treated. Elder patients had higher complication incidence and hospitalization rate. During follow-up, most lesions showed no changes in patients without treatment, no recurrence in patients received treatments.Conclusions: Esophageal leiomyoma progresses slowly and has a benign course. EUS is of great value in patients with esophageal leiomyoma. The diagnosis and treatment of elder patients with esophageal leiomyoma are different with non-elder ones, and EUS can provide scientific and reasonable methods to manage elder patients. submucosal lesions or external pressure neoplasms, for it cannot acquire specific information of a lesion's size, origin, and the relationship with nearby organs, potentially causing diagnostic confusion (2).
Keywords: Esophageal leiomyoma; endoscopic ultrasonography (EUS);Endoscopic ultrasonography (EUS) can clearly reveal the five-layered structure of the esophageal wall, and thereby confirm the nature, size, number, and origin of the lesions (3,5), and it is now an effective method of the diagnosis and treatment to esophageal leiomyomas.With the development and clinical application of EUS, the incidence of patients with esophageal leiomyomas is increasing, but there are few researches related were reported, especially in elder ones, whose diagnosis, differential diagnosis and treatment has its own particularity, so the clinical value of EUS in esophageal leiomyomas is worth further study.The purpose of this paper is to describe the EUS features, clinical features, auxiliary examinations features, treatment outcomes and follow-up results in patients with esophageal leiomyoma. Then concluded the clinical features of patients with esophageal leiomyoma, particularly in elder ones, investigating the diagnosis, differential diagnosis and treatment maki...