Abstract
Esophageal leiomyoma is a most common benign esophageal tumor, but the disease still presents difficulty in differentiation from leiomyosarcoma even today when the imaging diagnostic techniques have greatly developed. Further it is reportedly believed that endoscopic biopsy is difficult to differenti-ate whether a submucosal tumor is benign or malignant. Findings suggestive of malignancy include ulceration, rapid proliferating speed of the tumor.
This time we experienced a rare case of esophageal leiomyoma with ulceration. The case appeared to be of benign leiomyoma based on the tumor size and findings of an endoscopic biopsy, but was thought to be a candidate for operation because a malignant possibility could not be ruled out due to associated ulcer at the top of the tumor.
Since this tumor was of lamina muscularis mucosae origin, and the tumor cupular part had included ulceration, a wedge-shaped excision of the esophageal wall including the tumor was carried out by means of video-assisted thoracoscopic surgery (VATS).
This is the most important point of VATS operation for an esophageal submucosal tumor to let the tumor project with a balloon under endoscopy. When the tumor is small like in this case, especially, a more closer cooperation with Rev. endoscope doctor in charge is necessary.
