It is most frequently presents in young and middle age groups (20-50 years). The overall incidence is around 8-43 per 10,000 autopsy series 4.
The clinical presentation would often depend on the size of a tumour:
- small tumours (<5 cm): usually no symptoms
- large tumours: may cause dysphagia, regurgitation, oesophageal obstruction, chest pain, cough, or bleeding (rare)
Like other leiomyomas, they comprise of smooth muscle overgrowth.
They typically involve the mid-to-distal oesophagus 4.
On barium swallow, may be seen as a discrete ovoid mass that is well outlined by barium. Its borders form slightly obtuse angles with the oesophageal wall.
- ovoid intramural solitary mass with a smooth surface
- the presence of calcifications is almost pathognomonic
- narrowing of the oesophageal lumen
- may displace the oesophagus
- moderate diffuse contrast-enhancement
- no signs of invasion of adjacent tissue
Treatment and prognosis
The overall prognosis of these benign tumours is excellent. If a tumour is small (<5 cm) and asymptomatic treatment is not necessary. Otherwise, surgical enucleation is recommended 1,5.
Imaging differential considerations include:
- 1. Jiang W, Rice TW, Goldblum JR. Esophageal leiomyoma: experience from a single institution. Dis. Esophagus. 2013;26 (2): 167-74. doi:10.1111/j.1442-2050.2012.01345.x - Pubmed citation
- 2. Mutrie CJ, Donahue DM, Wain JC et-al. Esophageal leiomyoma: a 40-year experience. Ann. Thorac. Surg. 2005;79 (4): 1122-5. doi:10.1016/j.athoracsur.2004.08.029 - Pubmed citation
- 3. Tamura K, Takamori S, Tayama K et-al. Thoracoscopic resection of a giant leiomyoma of the esophagus with a mediastinal outgrowth. Ann Thorac Cardiovasc Surg. 1999;4 (6): 351-3. Pubmed citation
- 4. Yang PS, Lee KS, Lee SJ et-al. Esophageal leiomyoma: radiologic findings in 12 patients. Korean J Radiol. 2002;2 (3): 132-7. Free text at pubmed - Pubmed citation
- 5. Bonavina L, Segalin A, Rosati R et-al. Surgical therapy of esophageal leiomyoma. J. Am. Coll. Surg. 1995;181 (3): 257-62. Pubmed citation
- 6. Winant AJ, Gollub MJ, Shia J et-al. Imaging and clinicopathologic features of esophageal gastrointestinal stromal tumors. AJR Am J Roentgenol. 2014;203 (2): 306-14. doi:10.2214/AJR.13.11841 - Pubmed citation
- oesophageal dysmotility
- oesophageal tumours
- benign oesophageal neoplasms
- malignant oesophageal neoplasms
- gastro-oesophageal reflux disease
- oesophageal stricture