Abstract
BackgroundSquamous cell carcinoma is the most common epithelial tumor of the esophagus. Upper endoscopy with multiple minimally invasive biopsies should be performed to confirm the diagnosis. Leiomyoma of esophagus is rare, but it’s the most common benign submucosal mesenchymal tumor of the esophagus. The simultaneous occurrence of an overlying epithelial lesion and a mesenchymal lesion is very rare. This study aims to show a case operated due to squamous cell carcinoma of esophagus that was postoperatively diagnosed with coexistent esophageal leiomyoma and give a clear overview of the existing literature on it.Case presentationThe patient was a 41-year-old woman who underwent three field esophagectomy (McKeown). Pathological evaluation was done, and the patient had poorly differentiated squamous cell carcinoma and multiple leiomyomas. A leiomyoma was found with an invading overlying squamous cell carcinoma.ConclusionIt is concluded that esophageal carcinomas may coexist with leiomyomas; preexisting benign tumors may have played an important role in the development of the carcinoma by inducing constant stimulation of the overlying mucosa; endoscopic ultrasonography is recommended to avoid overestimating the extent of tumor invasion and the resultant aggressive radical surgery. As the developing countries had limited equipment, esophageal resection could be the modality of choice in the treatment.
Highlights
Squamous cell carcinoma is the most common epithelial tumor of the esophagus
It is concluded that esophageal carcinomas may coexist with leiomyomas; preexisting benign tumors may have played an important role in the development of the carcinoma by inducing constant stimulation of the overlying mucosa; endoscopic ultrasonography is recommended to avoid overestimating the extent of tumor invasion and the resultant aggressive radical surgery
As the developing countries had limited equipment, esophageal resection could be the modality of choice in the treatment
Summary
Squamous cell carcinoma is the most common epithelial tumor of the esophagus. Esophageal leiomyoma is rare, it’s the most common benign submucosal mesenchymal tumor (SMT) of the esophagus, originates from the cells of the smooth muscle, and form near the two-thirds (60–70%) of all benign tumors of the esophageal [1,2,3]. It almost appears as a single tumor, and multiple leiomyomas of the esophagus are extremely rare [1, 4]. There are some treatment recommendations proposed: (1) Superficial and limited mucosa disease (less than T1a), could undergo endoscopic resection, (2) Lesions penetrating the submucosa with negative lymph nodes (LNs) (more than T1b) could undergo direct surgical resection with lymphadenectomy, (3) Resectable lesions invading muscularis propria with positive LNs (less than T2N1) could receive neoadjuvant chemoradiation, (4) Locally advanced, unresectable or metastatic disease could receive palliative systemic therapy [6]
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