Esophageal leiomyoma: Laparotomic enucleation in a specialty center in the Amazon

Abstract

Introduction: Leiomyoma is considered a rare esophageal tumor, it is more common in the middle and distal esophagus and affects women from 20 to 69 years old. The objective of this article is to report the case of a young patient with digestive symptoms secondary to esophageal Leiomyoma that progressed to enucleation via laparotomy. Case Report: Young woman, 24 years old, experiencing symptoms of retrosternal pain and dry cough for two years, associated with progressive dysphagia from solids to liquids and weight loss. Upper digestive endoscopy showed a heterogeneous lesion in the distal esophagus and gastrointestinal seriography suggested extramucosal esophageal tumor. Computed tomography (CT) of the chest showed a lobulated formation in the distal esophagus, measuring 5.5 × 3.7 × 3.6 cm (L × T × AP), with a reduction in the luminal diameter in the distal esophagus. Conventional laparotomy treatment was chosen due to the size and location of the lesion at the esophagogastric confluence with tumor enucleation via the transesophageal abdominal route. The patient was discharged on the 4th postoperative day, stable, without symptoms, eating a soft diet orally. Conclusion: The diagnosis of esophageal leiomyoma, a rare disease with insidious evolution, was observed in a young patient, using an alternative access route to the established thoracotomy access. The appearance of symptoms is related to the size of the lesion, therefore, it should be investigated in patients with dysphagic symptoms with the aim of providing early diagnosis and less complex surgical treatment.