A CASE OF GIANT ESOPHAGEAL LEIOMYOSARCOMA

Abstract

A 61-year-old woman visited the institution because of gradually progressive dysphagia and dyspnea. Esophagography and CT revealed an esophageal submucosal tumor suspecting leiomyosarcoma. After the tumor was diagnosed as leiomyosarcoma pathologically during thoracotomy, esophagectomy, esophagostomy, and gastrostomy were performed. The operation was separated in two times because of her poor general condition. At the 2nd month after esophagogastrostomy, the patient died of DIC and MOF. Autopsy revealed infections of tissue of the whole body, but no bacterium was detected. No recurrence nor metastasis of sarcoma was observed. In this case the patient has dysphagia 3 years before, but, she had never consulted a nearby hospital when she first developed dyspnea. When she was seen at the institution, a collection of thoracic fluid and lowered lowered lung function were already present, which made some efficacious impossible. It is difficult to decide whether the myogenic tumor of the esophagus is benign or malignant. On the contrary, thoracotomy today can be performed safely and endoscopically resectable cases can be increasingly found. We should decide a surgical prosedure after correct diagnosis is made by strip biopsy in a small tumor or by thoracotomy in a large tumor like this patient.