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 .
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)
Like other leiomyomas, they comprise of smooth muscle overgrowth.
They typically involve the mid-to-distal esophagus.
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.
- 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 .
Imaging differential considerations include: