1. LEIOMYOMA OF OESOPHAGUS A BRIEF REVIEW
DR. L. GANAPATHIRAM
RESIDENT
DEPT OF GENERAL SURGERY
G.K.N.M. HOSPITAL
COIMBATORE:
INDIA

2. LEIOMYOMA OF OESOPHAGUS
INCIDENCE
MOST COMMON BENIGN TUMOUR OF OESOPHAGUS
6 % OF G.I. LEIOMYOMAS
2.4 % - MULTIPLE ORIGIN
MORE COMMON IN MALES THAN FEMALES : 1
AGE : YEARS.AVERAGE : 44 YEARS

3. LEIOMYOMA OF OESOPHAGUS
LOCATION
UPPER THIRD %
MID THIRD %
LOWER THIRD %
INTRAMURAL %
MEDIASTINAL %
MEDIASTINAL OUTGROWTH %

4. LEIOMYOMA OF OESOPHAGUS
PATHOLOGY
SIZE cm ( AVERAGE) FEW GIANT > 1 kg.
MULTIPLE TUMOURS %
CALCIFIED ENCAPSULATED %

5. LEIOMYOMA OF OESOPHAGUS
PATHOLOGY - GROSS
FIRM IN CONSISTENCY
SMOOTHLY ROUNDED
BOSSELATED
C/S - GREYISH WHITE / YELLOWISH
ENCAPSULATED BUT CAPSULE NOT PROMINENT

6. LEIOMYOMA OF OESOPHAGUS
PATHOLOGY - MICROSCOPY
BUNDLES OF SMOOTH MUSCLE FIBRES INTERLACED WITH FIBROUS TISSUE
LOW / ABSENT MITOTIC ACTIVITY
MALIGNANT TRANSFORMATION RARE

7. LEIOMYOMA OF OESOPHAGUS
SYMPTOMS
> 50 % ASYMPTOMATIC
DYSPHAGIA - LONG TERM PROGRESSIVE INTERMITTENT
VAGUE CHEST PAIN - LEFT SIDED
PYROSIS

8. LEIOMYOMA OF OESOPHAGUS
SYMPTOMS
HAEMORRHAGE EROSION OF MUCOSA RARE. < 10 CASES REPORTED

9. LEIOMYOMA OF OESOPHAGUS
INVESTIGATIONS
BARIUM SWALLOW SMOOTH,CRESCENT DEFECT IN THE CONTOUR OF O’PHAGUS LUMEN
OESOPHAGOSCOPY TO ASCERTAIN THE STATUS OF MUCOSA .SMOOTH BULGE INTO THE LUMEN. NOT TO BE BIOPSIED .

10. LEIOMYOMA OF OESOPHAGUS
INVESTIGATIONS
CT SCAN
AORTOGRAPHY MAINLY FOR LESIONS AROUND AORTIC ARCH

11. LEIOMYOMA OF OESOPHAGUS
ASSOCIATED DISEASES
HIATUS HERNIA
O’PHAGEAL DIVERTICULUM
CARCINOMA OF O’PHAGUS / STOMACH

12. LEIOMYOMA OF OESOPHAGUS
ASSOCIATED DISEASES
CARCINOMA OF LUNG / THYMUS
LEIOMYOMA OF OTHER ORGANS
HYPERTROPHIC OSTEOARTHROPATHY

13. LEIOMYOMA OF OESOPHAGUS
MANAGEMENT
SURGERY
TRANSTHORACIC ENUCLEATION
PREFERRED
(R) THORACOTOMY FOR UPPER & MID THIRD
(L) THORACOTOMY FOR LOWER THIRD

14. LEIOMYOMA OF OESOPHAGUS
MANAGEMENT
SURGERY
OESOPHAGEAL RESECTION
FOR LARGE TUMOURS
FOR ENCIRCLING TUMOURS

15. LEIOMYOMA OF OESOPHAGUS
MANAGEMENT
SURGERY
ENDOSCOPIC ENUCLEATION
NO MAJOR ROLE
ONLY FOR PEDUNCULATED & POLYPOID LESIONS
DANGERS OF PERFORATION

16. LEIOMYOMA OF OESOPHAGUS
PROGNOSIS
EXCELLENT
NO REPORT OF LEAK
NO REPORT OF RECURRENCE

17. LEIOMYOMA OF OESOPHAGUS
REFERENCES
Leiomyomata of Esophagus - An analysis of cases. Seremetis et al. Cancer 38:
Leiomyoma of Oesophagus. S.Muralidharan et al. Ind J Surg 41:52-53,1979.
Multiple Leiomyomas of Esophagus. Taylor et al. Ann Thor Surg 60: ,1995