Multiple Esophageal Leiomyoma Presenting with Clinical Dysphagia from Mechanical Obstruction and Motility Disorder

Wong, Thanawin; Pattarapuntakul, Tanawat; Keeratichananont, Suriya; Cattapan, Kamonwon; Nirattisaikul, Sitang; Wetwittayakhlung, Poowadon

doi:10.1159/000518861

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Imaging plays a significant role in assessing esophageal leiomyomatosis. In our case, the findings were consistent with previously reported cases, showing well-circumscribed intramural esophageal masses [ 6 - 8 ]. These imaging techniques aid in surgical planning and treatment decisions.…”

Section: Discussionsupporting

confidence: 93%

Dysphagia Unmasked: A Case Report of Esophageal Leiomyomatosis

Haji,

Faraj,

Abdulaziz

et al. 2023

Cureus

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Esophageal leiomyomatosis, an uncommon benign condition marked by the proliferation of smooth muscle cells within the esophageal wall, frequently presents diagnostic challenges due to its rarity and diverse clinical manifestations. In this case report, we document the clinical journey of a 28-year-old female who presented with a two-year history of progressive dysphagia. Upon physical examination and endoscopy, a submucosal mass in the lower esophagus was identified, prompting further imaging and subsequent biopsy, which confirmed the diagnosis of leiomyomatosis. A multidisciplinary team recommended surgical intervention, leading to a minimally invasive laparoscopic resection of the esophageal leiomyomas. Postoperatively, the patient experienced a substantial improvement in her dysphagia and was discharged in stable condition. This case not only underscores the importance of a multidisciplinary approach in achieving an accurate diagnosis but also highlights the successful application of minimally invasive surgical techniques for alleviating symptoms in esophageal leiomyomatosis patients. The rarity and varied clinical presentation of this condition emphasize the need for individualized and tailored management strategies.

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Section: Discussionsupporting

confidence: 93%

Dysphagia Unmasked: A Case Report of Esophageal Leiomyomatosis

Haji,

Faraj,

Abdulaziz

et al. 2023

Cureus

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“…The first treatment plan was esophagectomy and reconstruction with an esophagogastric anastomosis, as in the case of Thakut et al [ 3 ], since the prognosis of esophageal leiomyoma enucleation was difficult. We decided to perform thoracos-copy first to control the upper margin of the tumor, with the of the esophagus, but the most common site for these tumors is the distal third [ 6 ]. The most prevalent size of an esophageal leiomyoma is less than 5 cm in diameter.…”

Section: Discussionmentioning

confidence: 99%

A Large Esophageal Leiomyoma: Thoraco-Laparoscopic Enucleation or Esophagectomy and Reconstruction?

Pham,

Nguyen,

Tran

et al. 2023

Am J Case Rep

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Patient: Male, 59-year-old Final Diagnosis: Esophageal leiomyoma Symptoms: Dysphagia • progressive difficulty of swallowing Clinical Procedure: Surgery Specialty: Surgery Objective: Rare disease Background: Esophageal leiomyoma is a rare condition, with an estimated incidence rate of 0.4% of all esophageal neoplasms. These tumors are typically small, rarely more than 5 cm. The treatment depends on symptoms and the size and location of the tumor, with enucleation as the standard treatment of esophageal leiomyomas. Esophagectomy is performed only in very few cases, such as when the tumor is too large, there are multiple leiomyomas, there is a horseshoe shape or circumference, or the tumor is inextricably adhering to the esophageal mucosa. In such complex cases, it is often difficult to perform enucleation. However, with the risks of esophagectomy and intra-thoracic anastomosis, namely reflux, stenosis, leakage, abscess, and infection, attempting to perform enucleation for these cases should still be considered. Case Report: We reported a case of a large, multi-lobed, circumferential esophageal thoracoabdominal leiomyoma with successfully performed enucleation and esophageal preservation. A Dor fundoplication and Witzel jejunostomy tube were also performed. Follow-up 3 months postoperatively showed no appearance of reflux or dysphagia. The postoperative esophagogram visualized no obstruction or leakage. Histopathological results gave us concrete evidence of a leiomyoma: elongated cells with eosinophilic cytoplasm and rhomboid nuclei with uniform size. Conclusions: The thoraco-laparoscopic enucleation approach is the method that should be considered first in the treatment of large, multi-lobed, circumferential esophageal leiomyomas, before contemplating esophagectomy and reconstruction.

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Multiple Esophageal Leiomyoma Presenting with Clinical Dysphagia from Mechanical Obstruction and Motility Disorder

Cited by 2 publications

References 17 publications

Dysphagia Unmasked: A Case Report of Esophageal Leiomyomatosis

Dysphagia Unmasked: A Case Report of Esophageal Leiomyomatosis

A Large Esophageal Leiomyoma: Thoraco-Laparoscopic Enucleation or Esophagectomy and Reconstruction?

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