Oesophageal leiomyoma

Oesophageal leiomyoma is a benign smooth-muscle neoplasm of the oesophagus. It is the most common benign tumour of the oesophagus.

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 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.

Location

They typically involve the mid-to-distal oesophagus 4.

Fluoroscopy

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.

CT

Findings include:

  • 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

The overall prognosis of these benign tumours is excellent. If the tumour is small (<5 cm) and asymptomatic treatment is not necessary. Otherwise, surgical enucleation is recommended 1,5.

Imaging differential considerations include:

Oesophageal pathology
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Article Information

rID: 29510
Section: Pathology
Synonyms or Alternate Spellings:
  • Esophageal leiomyoma
  • Oesophageal leiomyomas
  • Oesophageal leiomyomata
  • Esophageal leiomyomas
  • Leiomyoma of oesophagus

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