Abstract
A 38-year-old female complaining of dysphagia was admitted to our hospital for treatment of an esophageal submucosal tumor. Esophagogastroduodenoscopy revealed a submucosal tumor in the cervico-thoracic esophagus. Pathological examination of the biopsy specimens showed interlacing bundles of pleomorphic spindle cells with numerous mitoses. Most of the spindle cells reacted strongly with antibody to Ki-67. Esophageal leiomyosarcoma was most likely, and larynx-preserving total esophagectomy and reconstruction using a gastric tube and a free jejunum graft with micro-vascular anastomosis through the retrosternal route were performed with a thoracoscopic surgery. Immunohistochemistry of the resected specimen revealed positivity for desmin and α-SMA and negativity for c-kit, CD34, S-100 protein, and keratin. The tumor was diagnosed as leiomyosarcoma histologically. The patient became to be able to eat most foods without aspiration, and has shown no signs of recurrence for six months after the surgery. We herein describe a case of a cervico-thoracic esophageal leiomyosarcoma in which radical operation was performed with a thoracoscopic surgery and in which the larynx function could be kept intact by a joint operation with head and neck surgery and plastic surgery.
