Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2020; 8(22): 5809-5815
Published online Nov 26, 2020. doi: 10.12998/wjcc.v8.i22.5809
Large leiomyoma of lower esophagus diagnosed by endoscopic ultrasonography–fine needle aspiration: A case report
Min Rao, Qing-Qing Meng, Pu-Jun Gao
Min Rao, Qing-Qing Meng, Department of Hepatology and Gastroenterology, The Second Part of First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Pu-Jun Gao, Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Rao M wrote the original manuscript with comprehensive review of the literature on the topic; Gao PJ edited the initial report and contributed to literature review; Meng QQ also contributed to editing the report.
Supported by the Natural Science Foundation of Science and Technology Department of Jilin Province, China. No. 20200201496JC.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest by any other the authors of this manuscript including Drs. Min Rao, Qing-Qing Meng, and Pu-Jun Gao.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pu-Jun Gao, PhD, Chief Doctor, Full Professor, Department of Hepatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, Jilin Province, China. gpj@jlu.edu.cn
Received: September 1, 2020
Peer-review started: September 1, 2020
First decision: September 12, 2020
Revised: September 17, 2020
Accepted: September 29, 2020
Article in press: September 29, 2020
Published online: November 26, 2020
Processing time: 85 Days and 4.7 Hours
Abstract
BACKGROUND

Benign esophageal tumors are rare accounting for < 1% of esophageal tumors; two-thirds of which are leiomyomas. Esophageal leiomyoma is a benign tumor derived from mesenchymal tissue that is completely muscularly differentiated. Most esophageal leiomyomas are < 5 cm. Esophageal leiomyomas > 5 cm are rare. We describe a case of a large esophageal leiomyoma involving the cardia and diaphragm.

CASE SUMMARY

A 35-year-old woman presented to the doctor because of a choking sensation after eating. Physical examination showed no positive signs. Gastroscopy indicated an uplifted change in the cardia. Enhanced computed tomography revealed space-occupying lesions in the lower part of the esophagus and cardia, which were likely to be malignant. Positron emission tomography–computed tomography showed increased metabolism of soft tissue masses in the lower esophagus and near the cardia. Malignant lesions were considered, and mesenchymal tumors were not excluded. Endoscopic ultrasonography was performed to examine a hypoechoic mass in the lower esophagus, which was unclear from the esophageal wall. Clinical evaluation suggested diagnosis of esophageal and cardiac stromal tumors. Finally, histological specimens obtained by endoscopic ultrasonography– fine needle aspiration suggested leiomyoma. The patient underwent laparoscopic local resection of the tumor. The postoperative pathological diagnosis was leiomyoma.

CONCLUSION

Endoscopic ultrasonography-fine needle aspiration is necessary for the diagnosis of gastrointestinal leiomyomas. It provides a strong basis for diagnosis of gastrointestinal tumors of unknown nature and origin.

Keywords: Esophageal tumor; Leiomyoma; Endoscopic ultrasonography; Fine needle aspiration; Endoscopic ultrasonography-fine needle aspiration; Case report

Core Tip: Endoscopic ultrasonography–fine needle aspiration is necessary for the diagnosis of gastrointestinal leiomyomas. It provides a strong basis for diagnosis of gastrointestinal tumors of unknown nature and origin.