Two resected cases of esophageal leiomyoma diagnosed with preoperative endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB)

Abstract

Leiomyoma is the most common submucosal tumor of the esophagus, and accurate preoperative diagnosis is diffi cult. We report herein on two resected cases of esophageal leiomyoma preoperatively diagnosed accurately with endoscopic ultrasound-guided fi ne-needle aspiration biopsy (EUS-FNAB). The fi rst patient, a 34-year-old man, had complained of dysphagia. Following EUS-FNAB, the pathological diagnosis was leiomyoma. Esophagectomy and reconstruction with a gastric tube were performed because the tumor had almost completely encircled the esophageal wall. The second patient, a 60-year-old woman, had complained of dysphagia. Following EUS-FNAB, the pathological diagnosis was leiomyoma. Enucleation of the tumor was performed because the tumor was not located in the entire circumference of the esophageal wall. The postoperative course of both patients was uneventful, and the fi nal pathological diagnosis of each case was leiomyoma. We conclude that EUS-FNAB is a useful method for diagnosing esophageal submucosal tumors and for selecting an appropriate surgical procedure.

Thoracoscopic enucleation for small-sized gastrointestinal stromal tumor of the esophagus: report of two cases

“…Distinguishing GIST from other esophageal mesenchymal tumors prior to operation used to be diffi cult, and a defi nite diagnosis was usually made using immunohistochemistry of the resected specimens. EUS-FNA can be used to obtain the tissue materials of gastrointestinal SMT, and evidence for the usefulness of EUS-FNA for the diagnosis of the gastric GIST has been accumulating [8,9], while its use for esophageal GIST has been described in few reports [10,11] and not been well defi ned because of, in part, the low incidence of these tumors. Some investigators have reported that the sensitivity of EUS-FNA for the diagnosis of GIST is infl uenced by size and location; the sensitivity correlates with increasing tumor size, and is higher when the GIST is located in the stomach [12,13].…”