Leiomyom Ösophagus
Leiomyome des
Ösophagus: Links und Mitte: Fälle aus der Breischluckuntersuchung: Glatte Begrenzung der in das Lumen ragenden Raumforderung. Oberhalb ist das Lumen durch die peristaltische Kontraktion nicht mehr sichtbar (links). Der Winkel zur angrenzenden Lumenkontur ist stumpf (submuköse Lage). Rechts: In der CT kann die rundliche Konfiguration des Tumors oft erst in sagittalen oder koronaren Reformatierungen dargestellt werden.
Video-thoracoscopic
enucleation of esophageal leiomyoma. A. Esophagogram of Case 10. Reveals typical findings of intramural tumor (T) near the esophago-gastric junction: smooth surface, clear-cut margins, and sharp angles at upper and lower ends of the tumor. E: esophagus. B. Endoscopic view of the esophageal leiomyoma (T). (Case 10).
Video-thoracoscopic
enucleation of esophageal leiomyoma. Computed tomography, cross section (A). Reveals the esophageal lumen being compressed forwards by horse-shoe shaped (T1 and T2) leiomyoma. Coronal section (B). Reveals this tumor (T) compressing the esophagus (E) and adjacent structures of mediastinum. (Case 9).
Imaging of
the oesophagus: beyond cancer. Leiomyoma. Esophagram in AP projection demonstrates a smooth, lobulated filling defect within the mid-thoracic oesophagus at the level of the carina. Notice the filling defect makes an acute angle to the oesophageal wall, suggesting that this lesion is intrinsic to the oesophagus
Esophageal
leiomyoma • Esophageal leiomyoma - Ganzer Fall bei Radiopaedia
Esophageal
leiomyoma • Gastroesophageal junction leiomyoma - Ganzer Fall bei Radiopaedia
Esophageal
leiomyoma • Esophageal leiomyoma - Ganzer Fall bei Radiopaedia
Esophageal
leiomyoma • Esophageal leiomyoma - Ganzer Fall bei Radiopaedia
Esophageal
leiomyoma • Esophageal leiomyoma - Ganzer Fall bei Radiopaedia
Esophageal
leiomyoma • Esophageal leiomyoma - Ganzer Fall bei Radiopaedia
Successful en
bloc endoscopic full-thickness resection of a giant cervical esophageal leiomyoma originating from muscularis propria. Evaluation of the SMT and the LeCamp™ endoloop device. a an endoscopic image revealed a protruding submucous lesion with a smooth surface. b CT image showing a 1.8 cm × 5.2 cm × 2.9 cm soft tissue mass. c EUS image showing a hypoechoic mass originated from the muscularis propria layer. d the LeCamp™ endoloop and its delivery system
Esophageal leiomyoma is a benign smooth muscle neoplasm of the esophagus. It is the most common benign tumor of the esophagus.
Epidemiology
It is most frequently presents in young and middle age groups (20-50 years). The overall incidence is around 8-43 per 10,000 autopsy series .
Clinical presentation
The clinical presentation would often depend on the size of a tumor:
- small tumors (<5 cm): usually no symptoms
- large tumors: may cause dysphagia, regurgitation, esophageal obstruction, chest pain, cough, or bleeding (rare)
Pathology
Like other leiomyomas, they comprise of smooth muscle overgrowth.
Location
They typically involve the mid-to-distal esophagus.
Radiographic features
Fluoroscopy
On barium swallow, may be seen as a discrete ovoid mass that is well outlined by barium. Its borders form slightly obtuse angles with the esophageal wall.
CT
Findings include:
- ovoid intramural solitary mass with a smooth surface
- the presence of calcifications is almost pathognomonic
- narrowing of the esophageal lumen
- may displace the esophagus
- moderate diffuse contrast-enhancement
- no signs of invasion of adjacent tissue
Treatment and prognosis
The overall prognosis of these benign tumors is excellent. If a tumor is small (<5 cm) and asymptomatic treatment is not necessary. Otherwise, surgical enucleation is recommended .
Differential diagnosis
Imaging differential considerations include:
- esophageal GIST
- esophageal carcinoma
- esophageal leiomyosarcoma
- esophageal hamartoma
- other mediastinal tumors arising close to the esophagus
- foreign body
Siehe auch:
- Lipom
- Ösophaguskarzinom
- benigne Ösophagustumoren
- Leiomyom
- Fibrovaskulärer Polyp des Ösophagus
- Granularzelltumor des Ösophagus
- Leiomyomatose des Ösophagus
- Neurofibrom des Ösophagus
- papilloma of the esophagus
- Schwannom des Ösophagus
- Hämangiom des Ösophagus
und weiter:
Assoziationen und Differentialdiagnosen zu Leiomyom Ösophagus:
