TWO RESECTED CASES OF LEIMYOSARCOMA OF THE ESOPHAGUS WHICH WERE SUCCESSFULLY DIAGNOSED PREOPERATIVELY

Abstract

Primary leiomyosarcoma of the esophagus is a rare disease. It is hardly diagnosed preoperatively, because it is a submucosal tumor. Recent experience with 2 cases of leiomyosarcoma of the esophagus, in which we were able to perform radical operation under the definite diagnosis resulting from preoperative examinations, is reported.Case 1 is an 81-year-old woman complaining of dysphagia. An esophagogram revealed a tumor of 6 cm in longer diameter in Ei region. Esophagoscopy showed a protruded lesion lobulating like a polyp, locating at 30 cm from the incisor line. As as result of biopsy, it was diagnosed as leiomyosarcoma. Intrathoracic anastomosis of the esophagus and remnant stomach under left thoracoabdominal incision was performed. The excised tumor was 3.5×6.0cm in size, presenting as protruded type with lobulation. Histopathologically it was leiomyosarcoma of the esophagus with a metastasis in the left cardiac lymph node.Case 2 was a 61-year-old man complaining of dysphagia and hematemesis. An esophagogram revealed a tumor 8 cm in longer diameter in the EiC region, presenting as tumor type with ulceration. Esophagoscopy showed a protruded lesion with a high of about 2.5 cm locating at 40 cm from the incisor line, which was accompanied with deep ulcer on the anal side. As a result of biopsy, it was found a leiomyosarcoma. Jejunal interposition between the esophagus and remnant stomach under left thoracoabdominal incision was performed. Excised specimen was 4.5×6.0×4.0 cm in size. Histopathologically it was a leiomyosarcoma.