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A Completely Calcified Esophageal Leiomyoma
A Completely Calcified Esophageal Leiomyoma Sokratis Tsagkaropoulos, MD, Federico Francioni, MD, Valbona Telha, MD, and Tiziano De Giacomo, MD
FEATURE ARTICLES
Department of Thoracic Surgery, University of Roma “Sapienza,” Rome, Italy
Fig 1.
A
70-year-old man with a 1-month history of dysphagia was admitted to our institution. A barium swallow demonstrated a mild filling defect and a well-defined calcified U-shaped area around the esophagus below the level of the aortic arch. A computed tomography scan of the chest confirmed a calcified mass involving the esophageal wall for about 70% of its circumference (Fig 1). An endoscopic ultrasound scan revealed a hypoechoic lesion with an important 30-cm calcified component with intact mucosa, arising in the muscularis propria, almost encircling the esophagus, and narrowing the lumen. The patient underwent a right video-assisted minithoracotomy (5-cm incision at the fifth intercostal space), and a large leiomyoma was enucleated by dissection within the muscular wall of the esophagus, leaving intact the esophageal mucosa (Fig 2). The histologic exam revealed a completely calcified leiomyoma of the esophagus. No smooth muscle cells were present.
Address correspondence to Dr Tsagkaropoulos, Policlinico Umberto I, Cattedra di Chirurgia Toracica, Viale del Policlinico 155, 00161 Rome, Italy; e-mail: [email protected].
© 2011 by The Society of Thoracic Surgeons Published by Elsevier Inc
Fig 2.
The patient had an uneventful postoperative course. A control Gastrografin (Bayer Schering Pharma AG, Berlin, Germany) swallow showed no abnormalities, and he was discharged 5 days after the operation. Leiomyomas are the most common benign mesenchymal tumors of the esophagus, and dysphagia is the main symptom. More than 80% of these tumors occur in the middle and lower third of the esophagus. They are histologically composed of bundles of smooth cells and can be partially or completely calcified [1]. Surgical enucleation is the common treatment when symptoms are present.
Reference 1. CJ Mutrie, DM Donahue, JC Wain, et al. Esophageal leiomyoma: a 40-year experience. Ann Thorac Surg 2005;79:1122–5.
Ann Thorac Surg 2011;91:1293 • 0003-4975/$36.00 doi:10.1016/j.athoracsur.2010.09.027
FEATURE ARTICLES
Department of Thoracic Surgery, University of Roma “Sapienza,” Rome, Italy
Fig 1.
A
70-year-old man with a 1-month history of dysphagia was admitted to our institution. A barium swallow demonstrated a mild filling defect and a well-defined calcified U-shaped area around the esophagus below the level of the aortic arch. A computed tomography scan of the chest confirmed a calcified mass involving the esophageal wall for about 70% of its circumference (Fig 1). An endoscopic ultrasound scan revealed a hypoechoic lesion with an important 30-cm calcified component with intact mucosa, arising in the muscularis propria, almost encircling the esophagus, and narrowing the lumen. The patient underwent a right video-assisted minithoracotomy (5-cm incision at the fifth intercostal space), and a large leiomyoma was enucleated by dissection within the muscular wall of the esophagus, leaving intact the esophageal mucosa (Fig 2). The histologic exam revealed a completely calcified leiomyoma of the esophagus. No smooth muscle cells were present.
Address correspondence to Dr Tsagkaropoulos, Policlinico Umberto I, Cattedra di Chirurgia Toracica, Viale del Policlinico 155, 00161 Rome, Italy; e-mail: [email protected].
© 2011 by The Society of Thoracic Surgeons Published by Elsevier Inc
Fig 2.
The patient had an uneventful postoperative course. A control Gastrografin (Bayer Schering Pharma AG, Berlin, Germany) swallow showed no abnormalities, and he was discharged 5 days after the operation. Leiomyomas are the most common benign mesenchymal tumors of the esophagus, and dysphagia is the main symptom. More than 80% of these tumors occur in the middle and lower third of the esophagus. They are histologically composed of bundles of smooth cells and can be partially or completely calcified [1]. Surgical enucleation is the common treatment when symptoms are present.
Reference 1. CJ Mutrie, DM Donahue, JC Wain, et al. Esophageal leiomyoma: a 40-year experience. Ann Thorac Surg 2005;79:1122–5.
Ann Thorac Surg 2011;91:1293 • 0003-4975/$36.00 doi:10.1016/j.athoracsur.2010.09.027