Leiomyoma of the Esophagus

Solomon, Mark P.; Rosenblum, Harry M.; Rosato, Francis E.

doi:10.1097/00000658-198402000-00020

Cited by 32 publications

(9 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In all of our cases, endosonographic findings by endoprobe were exactly concordant with pathologic findings of resected tumors. Leiomyomas have a tendency toward continuous endoluminal growth and the possibility of malignant transformation 8. Preoperative pathological diagnosis of a smooth muscle cell tumor is impossible because the differentiation of benign and malignant smooth muscle tumors is mainly based on the mitotic figures of several fields of entire resected specimen.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of Endoprobe for Small Esophageal Leiomyomas Derived from the Muscularis Mucosae

et al. 2005

View full text Add to dashboard Cite

Esophageal leiomyoma derived from the muscularis mucosae (MM) is a rare condition, and the optimal modality for diagnosis and treatment is controversial. Endoscopic ultrasonography can provide an accurate image of esophageal layer structure, providing information on lesion suitability for potential endoscopic therapy. We attempted to investigate the diagnostic value of a transendoscopic balloon-tipped miniature ultrasonic endoprobe for small esophageal leiomyomas derived from MM. We resected 7 small esophageal leiomyomas derived from MM by endoscopic mucosal resection (EMR), all of which were diagnosed by a balloon-tipped endoprobe. The endosonographic and pathologic features of 7 cases of small esophageal leiomyomas derived from MM were compared. The balloon-tipped endoprobe clearly showed all 7 small esophageal leiomyomas derived from MM, even those under 5 mm in size (smallest lesion, 3.0 mm). The endosonographic characteristics of small esophageal leiomyomas derived from MM were a hypoechoic mass with smooth, regular, and a well-defined outer margin and homogenous inner echogram arising from the second hypoechoic layer. Complete resections were possible in all 7 cases by EMR without any complications. Tumor size was 3.0 - 13.5 mm (mean 7.8 mm) in maximum diameter. In all cases, endosonographic findings by endoprobe were exactly concordant with pathologic finding in determining the tumors depth in the esophageal wall, tissue origin and characteristics, growth pattern, and size. We detail the balloon-tipped endoprobe is a simple, convenient, and very useful in making accurate diagnosis of small esophageal leiomyomas derived from the MM and the appropriate applications of EMR.

show abstract

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of Endoprobe for Small Esophageal Leiomyomas Derived from the Muscularis Mucosae

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Three of the eight (38%) esophageal GISTs were ulcerated at endoscopy, whereas no esophageal leiomyoma showed mucosal ulceration. Indeed, multiple other sources have found that ulceration is exceedingly rare in esophageal leiomyoma [4, 19]. Mucosal ulceration was common in esophageal GISTs larger than 4.5 cm and also in left-sided esophageal GISTs with mixed spindle-epithelioid histopathology.…”

Section: Discussionmentioning

confidence: 99%

Imaging and Clinicopathologic Features of Esophageal Gastrointestinal Stromal Tumors

Winant

Gollub

Shia

et al. 2014

American Journal of Roentgenology

View full text Add to dashboard Cite

OBJECTIVE The purpose of this article is to describe the imaging and clinicopathologic characteristics of esophageal gastrointestinal stromal tumors (GISTs) and to emphasize the features that differentiate esophageal GISTs from esophageal leiomyomas. MATERIALS AND METHODS A pathology database search identified all surgically resected or biopsied esophageal GISTs, esophageal leiomyomas, and esophageal leiomyosarcomas from 1994 to 2012. Esophageal GISTs were included only if imaging studies (including CT, fluoroscopic, or 18F-FDG PET/CT scans) and clinical data were available. RESULTS Nineteen esophageal mesenchymal tumors were identified, including eight esophageal GISTs (42%), 10 esophageal leiomyomas (53%), and one esophageal leiomyosarcoma (5%). Four patients (50%) with esophageal GIST had symptoms, including dysphagia in three (38%), cough in one (13%), and chest pain in one (13%). One esophageal GIST appeared on barium study as a smooth submucosal mass. All esophageal GISTs appeared on CT as well-marginated predominantly distal lesions, isoattenuating to muscle, that moderately enhanced after IV contrast agent administration. Compared with esophageal leiomyomas, esophageal GISTs tended to be more distal, larger, and more heterogeneous and showed greater IV enhancement on CT. All esophageal GISTs showed marked avidity (mean maximum standardized uptake value, 16) on PET scans. All esophageal GISTs were positive for c-KIT (a cell-surface transmembrane tyrosine kinase also known as CD117) and CD34. On histopathology, six esophageal GISTs (75%) were of the spindle pattern and two (25%) were of a mixed spindle and epithelioid pattern. Five esophageal GISTs had exon 11 mutations (with imatinib sensitivity). Clinical outcome correlated with treatment strategy (resection plus adjuvant therapy or resection alone) rather than risk stratification. CONCLUSION Esophageal GISTs are unusual but clinically important mesenchymal neoplasms. Although esophageal GISTs and esophageal leiomyomas had overlapping imaging features, esophageal GISTs tended to be more distal, larger, more heterogeneous, and more enhancing on CT and were markedly FDG avid on PET. Given their malignant potential, esophageal GISTs should be included in the differential diagnosis of intramural esophageal neoplasms.

show abstract

“…The formation of an esophageal diverticulum in one case alert for mandatory approach of the muscular layer, as a way to prevent it. The risk of esophageal mucosal injury is approximately 10% 16 , which requires attention, since in these cases there is a great chance to convert the procedure to open operation. Were used four trocars in thoracoscopic approach, which differs from some authors that recommend the use of five work channels 1,5,6 .…”

Section: Discussionmentioning

confidence: 99%

“…Lesions are uncommon in the upper third (11%). Approximately 97% of esophageal leiomyomas arise as intramural growths and 3% are presented as polyps 10,15,16 . At least 50% of patients with esophageal leiomyoma remain asymptomatic.The most common presenting symptom is dysphagia and can be associated with chest pain, retrosternal discomfort, pyrosis and weight loss.…”

Section: Introductionmentioning

confidence: 99%

Tratamento videoendoscópico do leiomioma de esôfago

Pinheiro

Campos

Matos

et al. 2013

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

- RESUMO -Introdução:Leiomiomas são as neoplasias esofagianas mais comuns. Seu tratamento de escolha é cirúrgico. A enucleação por toracotomia aberta é o procedimento padrão. Com o avanço das técnicas de cirurgia minimamente invasiva, novas alternativas se impõem. Objetivo: Apresentar técnica videoendoscópica para o tratamento desses miomas evitandose toracotomia. Técnica: Enucleação do leiomioma por: A) toracoscopia para tumores do esôfago torácico ou B) laparoscopia aos do esôfago abdominal. A) As operações são realizadas sob anestesia geral com entubação seletiva do pulmão esquerdo. Os pacientes são colocados em posição de decúbito lateral esquerdo e leve dorsoflexão. São utilizados quatro trocárteres de trabalho, dois de 11 mm e dois de 5 mm. Os de 11 mm, um no 6º espaço intercostal, na linha axilar posterior, para ótica de 30°; outro na mesma altura na linha hemiclavicular para afastar o pulmão. Os outros dois trocárteres de 5 mm são instalados para dar passagem aos instrumentos de trabalho do cirurgião no 4º espaço, na linha axilar posterior, e no 7º, também na linha axilar posterior. As operações se iniciavam sempre pela abertura da pleura mediastinal, dissecção do tumor com abertura da parte muscular da parede esofágica, enucleação simples do tumor e fechamento da incisão muscular esofágica. B) As intervenções são feitas com os pacientes submetidos à anestesia geral e colocados em posição francesa. A abordagem é a mesma realizada para correção da hérnia hiatal e a enucleação é feita sem dificuldades. Conclusão: O acesso videocirúrgico é perfeitamente exequível para as ressecções de leiomiomas esofágicos e proporciona resultados satisfatórios muito semelhantes aos encontrados com aos procedimentos abertos.

show abstract

Leiomyoma of the Esophagus

Abstract: Esophageal leiomyoma, while rare, is the most common benign tumor of the esophagus. Nine cases from a large teaching hospital are reviewed with long-term follow-up. Steps in the diagnosis and management of this lesion are discussed.

Cited by 32 publications

References 5 publications

The Diagnostic Value of Endoprobe for Small Esophageal Leiomyomas Derived from the Muscularis Mucosae

The Diagnostic Value of Endoprobe for Small Esophageal Leiomyomas Derived from the Muscularis Mucosae

Imaging and Clinicopathologic Features of Esophageal Gastrointestinal Stromal Tumors

Tratamento videoendoscópico do leiomioma de esôfago

Contact Info

Product

Resources

About