Tumors of the Esophagus

Abstract

This collective review includes all available case reports of smooth muscle (stromal) tumors of the esophagus in the world literature. Compiling this review, we endeavored to examine cumulative and recently collected data of both benign and malignant esophageal smooth muscle tumors found in the literature spanning the period from 1875 to 1996, which totaled 1679 leiomyomas (LMs) and 165 leiomyosarcomas (LMSs). The peak age of occurrence of benign smooth muscle tumors in the esophagus was found to be between the ages of 30 and 59, whereas the highest frequency of malignant tumors was seen later in life, during the decade from age 60 to 69. The most common location of both LMs and LMSs was the lower third of the esophagus. Their patterns of growth differed; LMs were more likely to grow intramurally, and LMSs were predominantly intraluminal. Most patients with LMs presented with dysphagia and pain or discomfort; patients with LMSs additionally commonly complained of weight loss. As with smooth muscle tumors of other areas of the gastrointestinal tract, the duration of symptoms averaged 1 month to 1 year, and malignant tumors grew to larger sizes than benign neoplasms. Approximately one-third of LMSs had metastasized at diagnosis, and there was a 5-year survival rate of approximately 20%.

Esophageal resection for giant leiomyoma: report of two cases and a review of the literature

“…Compared to leiomyosarcoma that mostly occur in ages 50 to 70, patients with esophageal leiomyoma are often younger, with a peak incidence in the third to fifth decade [1]. However, one can roughly differentiate leiomyoma from malignant tumors, as the onset of symptoms is slowly increasing and weight loss is rare (Table 1) [1]. Upon endoscopic examination, leiomyoma often shows an intact mucosal surface, and the tumor appears as a compression of the esophageal lumen by a mediastinal mass.…”

“…Differential diagnoses include malignant esophageal tumors such as squamous or adenomatous carcinomas or leiomyosarcoma. Compared to leiomyosarcoma that mostly occur in ages 50 to 70, patients with esophageal leiomyoma are often younger, with a peak incidence in the third to fifth decade [1]. However, one can roughly differentiate leiomyoma from malignant tumors, as the onset of symptoms is slowly increasing and weight loss is rare (Table 1) [1].…”

“…Even a diffuse leiomyomatosis of the esophagus has been described [4]. A peak incidence of esophageal leiomyoma occurs between ages 30 and 60, and the male sex predominates (ratio male to female approximately 2:1) [1]. Most patients with esophageal leiomyomas are asymptomatic.…”

“…Esophageal leiomyomas are the most common benign tumors of the esophagus [1]. However, esophageal carcinoma is approximately 50 times more frequent than esophageal leiomyoma [2].…”

“…Esophageal leiomyomas show an incidence of approximately 8-43/ 10,000 in autopsy series. Leiomyomas are slow growing intramural tumors usually located in the middle and lower part of the esophagus [1]. In general, they are single lesions, but sometimes, multiple tumors are present [3].…”