Incidental Discovery of an Esophageal Leiomyoma: Thoracoscopic Surgical Approach

Abstract

Background: Esophageal leiomyomas are the most common benign esophageal tumor, originating in the smooth muscle of the esophagus. Patients may accuse dysphagia, epigastric pain, but in 50% of cases are asymptomatic. Paraclinical exams used to highlight the esophageal tumor are esophageal and stomach barium swallow, esophagoscopy, chest CT scan, endoscopic ultrasonography. Thoracoscopic enucleation in recent years has gained many followers. Case Report: We present herein the case of 43 years old patient admitted in our department for thoracic trauma; the CT scan revealed a tumor in the middle third of the esophagus suggestive for a leiomyoma. Upper GI endoscopy showed an extrinsic compression in the middle third of the esophagus, without mucosal lesions, and esophageal barium swallow showed a slight narrowing of the lumen at this level. Given the findings suggestive of a benign esophageal tumor, possible esophageal leiomyoma, thoracoscopic approach was chosen. We performed a thoracoscopic enucleation with uneventful postoperative follow-up. Histopathology confirmed the diagnosis of esophageal leiomyoma. Conclusions: Thoracoscopic enucleation is a feasible method to treat esophageal leiomyomas.