Tripurari Mishra, MD1, Shanu N Kothari, MD2. 1Gundersen Medical Foundation, 2Gundersen Health System
Esophageal leiomyoma are benign tumors that arise from smooth muscles. It is present in the distal third of the esophagus 60% of the time, 30% in the middle and 10% in the upper esophagus. Barium swallow shows a smooth a filling defect within the esophageal defect. CT scans can show a soft tissue mass. EGD/EUS can be used to confirm the diagnosis.
A 61-year-old male presented with troublesome cough. He denied any dysphagia or heartburn and had a greater than 25 pack-year smoking history. Due to significant smoking history and chronic cough, a CT scan was obtained, which incidentally showed 3.4×3.4×5.6 cm soft tissue mass in the distal esophagus. EGD with EUS and fine needle aspiration were performed and the biopsy results were consistent with leiomyoma. Given the size and location of the mass, a laparoscopic resection of the mass was performed. Mucosal integrity was maintained through the resection and confirmed using an endoscope. The patient recovered uneventfully after the surgery and was discharged on postoperative day 1.
Surgical indications for resection for leiomyoma include unremitting symptoms, increased tumor size, mucosal ulceration, histopathologic diagnosis, concern for malignant transformation, and facilitation of other surgical procedures. When feasible, laparoscopic approaches are favored over thoracoscopic to decrease pulmonary morbidity.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93459
Program Number: V005
Presentation Session: Foregut I
Presentation Type: Video