Which is true about esophageal leiomyoma?
Ans. is 'b' i.e., Appears like an ovoid intramural mass with smooth outline on CTo Oesophageal leiomyoma is a benign smooth-muscle neoplasm of the oesophagus. It is the most common benign tumour of the oesophagus.Epidemiologyo 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 4.Clinical presentationo The clinical presentation would often depend on the size of tumour:# small tumours (<5 cm): usually no symptoms# large tumours: may cause dysphagia, regurgitation, oesophageal obstruction,chest pain, cough, bleeding (rare)Pathologyo Like other leiomyomas, they comprise of smooth muscle overgrowth.Locationo They typically involve the mid-to-distal oesophagus.Radiographic featureso Fluoroscopyo 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 oesophageal wall.CTo Findings include:# Ovoid intramural solitary mass with a smooth surface# The presence of calcifications is almost pathognomonic# Narrowing of oesophageal lumen# May displace the oesophagus# Moderate diffuse contrast-enchancement# No signs of invasion of adjacent tissueTreatment and prognosiso The overall prognosis of these benign tumours is excellent. If tumour is small (<5 cm) and asymptomatic treatment is not necessary. Otherwise surgical enucleation is recommended
Common in proximal third of esophagus
Appears like an ovoid intramural mass with smooth outline on CT
It is mass of skeletal muscle overgrowth
Prognosis is generally poor
Benign Esophageal Lesions