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

Rijcken E, Kersting CM, Senninger N, Bruewer M

Abstract

INTRODUCTION: Big masses of the mediastinum causing dysphagia are both a diagnostic and a therapeutic challenge for gastroenterologists and surgeons. Besides of hernia and cysts, lymphomas, neurogenic as well as benign or malignant mesenchymal tumors are potential diagnoses. Since biopsies are often not conclusive, mostly the diagnosis can only be secured postoperatively. CASE REPORTS: In this article, we report on two cases of giant esophageal leiomyoma, in which radical surgical resection was performed for the relief of symptoms and to secure diagnosis accurately. The specimen revealed tumors of 750 and 550 g, respectively. Only histological and immunohistochemical examination could rule out malignant low grade leiomyosarcoma. CONCLUSION: Esophageal leiomyomas are approximately 50 times less common than carcinoma, but they are the most common benign tumors of the esophagus. Whereas removal of the tumor by enucleation by conventional thoracotomy or thoracoscopy can be performed in most cases, esophagectomy is required for giant tumors of the esophagus.