Esophageal leiomyoma

Last revised by Mostafa Elfeky on 23 May 2023

Esophageal leiomyoma is a benign smooth muscle neoplasm of the esophagus. It is the most common benign tumor of the esophagus.

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 tumor:

  • small tumors (<5 cm): usually no symptoms
  • large tumors: may cause dysphagia, regurgitation, esophageal obstruction, chest pain, cough, or bleeding (rare)

Like other leiomyomas, they comprise smooth muscle overgrowth.

They typically involve the mid-to-distal esophagus 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 esophageal wall.

Findings include:

  • ovoid intramural solitary mass with a smooth surface
  • the presence of calcifications is almost pathognomonic 
  • narrowing of the esophageal lumen
  • may displace the esophagus
  • moderate diffuse contrast-enhancement
  • no signs of invasion of adjacent tissue

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

Imaging differential considerations include:

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.