A CASE OF ESOPHAGEAL LEIOMYOMA SHAPED LIKE A HORSESHOE

Abstract

In July 1990, a 29-year-old man showed an abnormal shadow in a chest roentgenogram in a routine health examination. He was diagnosed with submucosal tumor (SMT) in the lower esophagus and his clinical course was observed. In December 1997, he was admitted to our hospital because of growth of the tumor. Esophagography revealed a filling defect shadow, 5cm in diameter, in the left wall of the lower esophagus, but endoscopy showed no ulcer. Computed tomography showed a low density tumor shaped like a horseshoe in the lesion. He was diagnosed with leiomyoma and an operation was perfomed. Thoracotomy on the left 7th intercostal route was performed, finding a tumor in the shape of a horseshoe in the lower esophagus, projecting to the thoracic cavity. The tumor did not invade the surrounding tissue, and we treated it successfully by enucleation without injury of the mucosa. The resected specimen was 7.5×5×5cm in size, and the cut surface of the solid tumor was light yellow. The diagnosis of leiomyoma was confirmed histopathologically.
We concluded that SMT shaped like a horseshoe in the lower esophagus is characteristic of leiomyoma, and we should perform enucleation if possible to preserve the functions of the esophagus and stomach.