Endoscopic Ultrasonography in the Diagnosis and Treatment Strategy Choice of Esophageal Leiomyoma

  • Ling-Jia Sun Ningbo No. 2 Hospital; Department of Gastroenterology
  • Xin Chen Zhejiang University; Department of Gastroenterology
  • Yi-Ning Dai Zhejiang University; Department of Gastroenterology
  • Cheng-Fu Xu Zhejiang University; Department of Gastroenterology
  • Feng Ji Zhejiang University; Department of Gastroenterology
  • Li-Hua Chen Zhejiang University; Department of Gastroenterology
  • Hong-Tan Chen Zhejiang University; Department of Gastroenterology
  • Chun-Xiao Chen Zhejiang University; Department of Gastroenterology
Keywords: Endoscopic Ultrasonography, Esophageal Leiomyoma, Diagnosis and Treatment Strategy

Abstract

OBJECTIVES: Esophageal leiomyoma is the most common benign tumor of the esophagus, and it originates from mesenchymal tissue. This study analyzed the clinicopathological characteristics of esophageal leiomyoma and aimed to evaluate the role of endoscopic ultrasonography in the diagnosis and treatment selection for these lesions. METHODS: Two hundred and twenty-five patients who had suspected esophageal leiomyomas in endoscopic ultrasonography were enrolled at the Endoscopy Center of The First Affiliated Hospital, Zhejiang University from January 1st, 2009 to May 31th, 2015. The main outcomes included the demographic and morphological characteristics, symptoms, comparisons of diagnosis and treatment methods, adverse events, and prognosis. RESULTS: One hundred and sixty-seven patients were diagnosed as having an esophageal leiomyoma by pathological examination. The mean patient age was 50.57±9.983 years. In total, 62.9% of the lesions originated from the muscularis mucosa, and the others originated from the muscularis propria. The median distance to the incisors was 30±12 cm. The median diameter was 0.72±0.99 cm. As determined by endoscopic ultrasonography, most existing leiomyomas were homogeneous, endophytic, and spherical. The leiomyomas from the muscularis mucosa were smaller than those from the muscularis propria and much closer to the incisors (p<0.05). SMA (smooth muscle antibody) (97.2%) and desmin (94.5%) were positive in the majority of patients. In terms of treatments, patients preferred endoscopic therapies, which led to less adverse events (e.g., intraoperative bleeding, local infection, pleural effusion) than surgical operations (p<0.05). The superficial leiomyomas presented less adverse events and better recovery (p<0.05) than deep leiomyomas. CONCLUSION: Endoscopic ultrasonography has demonstrated high accuracy in the diagnosis of esophageal leiomyomas and provides great support in selecting treatments; however, EUS cannot completely avoid misdiagnosis, so combining it with other examinations may be a good strategy to solve this problem.

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Published
2017-04-01
How to Cite
Sun, L.-J., Chen, X., Dai, Y.-N., Xu, C.-F., Ji, F., Chen, L.-H., Chen, H.-T., & Chen, C.-X. (2017). Endoscopic Ultrasonography in the Diagnosis and Treatment Strategy Choice of Esophageal Leiomyoma. Clinics, 72(4), 197-201. https://doi.org/10.6061/clinics/2017(04)01
Section
Clinical Sciences