CASE PRESENTATION

2010-07-09
R3 이진영
 CASE
• 10019978 59/M
• C.C: Dysphagia (onset: 1 month ago)
 Pathology
• Op name:
Enucleation of esophageal tumor
– DIAGNOSIS: leiomyoma
 Esophageal leiomyoma
• M/C benign tumor of esophagus
(But rare 8-43 / 10,000 autopsy series)
– Histologically
• Intersecting bands of muscle & fibrous T. in capsule
• Muscularis propria, submucosa, or muscularis mucosae
– Distal third of esophagus, solitary (3% : multiple)

• Clinical feature
– 20-60 years old, males
– If <5cm, usually asx
– If large, dysphagia, retrosternal discomfort or pain,
esophageal obstruction & regurgitation
 Imaging finding
• Radiographic finding
– Smoothly marginated, round or lobulated mass
projecting to one or both sides of mediastinum
along course of esophagus
– Occasionally punctate calcification

• Esophagography
– Eccentric, smoothly elevated filling defects
– Ulcer: rare
 Imaging finding
• CT finding
– Well defined, with smooth, sharp borders,
homogeneous intramural mass or wall thickening
size: 2 to 8 cm
– Occasionally esophageal bleeding
coarse calcifications

• MR finding
– T1WI : slightly hyperintensity
– T1WI + C: slight homogeneous enhancement
– T2WI : iso to slightly hyperintensity
Esophageal Leiomyoma: A 40-Year Experience
Ann Thorac Surg 2005;79:1122-1125
 Esophageal leiomyomatosis
associated respiratory compromise
• Its potential to involve adjacent structure
• Compress adjacent main air way

Case 1.
Case 2.
• Esophageal Leiomyoma:
Radiologic Findings in 12 Patients
Korean J Radiol 2001;2:132-137
• Multimodality Diagnostic Imaging of Diff
use Esophageal Leiomyomatosis
J Comput Assist Tomogr 2006;30:100–10
4