Korean J Radiol.  2001 Sep;2(3):132-137. 10.3348/kjr.2001.2.3.132.

Esophageal Leiomyoma: Radiologic Findings in 12 Patients

• Yang PS
• Lee KS
• Lee SJ
• Kim TS
• Choo IW
• Shim YM
• Kim K
• Kim Y

• KMID: 754097
• DOI: http://doi.org/10.3348/kjr.2001.2.3.132

Abstract

OBJECTIVE
The aim of our study was to describe and compare the radiologic findings of esophageal leiomyomas. MATERIALS AND METHODS: The chest radiographic (n = 12), esophagographic (n = 12), CT (n = 12), and MR (n = 1) findings of surgically proven esophageal leiomyomas in 12 consecutive patients [ten men and two women aged 34 - 47 (mean, 39) years] were retrospectively reviewed. RESULTS: The tumors, surgical specimens of which ranged from 9 to 90 mm in diameter, were located in the upper (n = 1), middle (n = 5), or lower esophagus (n = 6). In ten of the 12 patients, chest radiography revealed the tumors as mediastinal masses. Esophagography showed them as eccentric, smoothly elevated filling defects in 11 patients and a multilobulated encircling filling defect in one. In 11 of the 12 patients, enhanced CT scans revealed a smooth (n = 9) or lobulated (n = 2) tumor margin, and attenuation was homogeneously low (n = 7) or iso (n = 4). In one patient, the tumor signal seen on T2-weighted MR images was slightly high. CONCLUSION: Esophageal leiomyomas, located mainly in the middle or distal esophagus, are consistently shown by esophagography to be mainly eccentrically elevated filling defects and at CT, lesions showing homogeneous low or isoattenuation are demonstrated.

Keyword

Esophagus, abnormalities; Esophagus, CT; Esophagus, MR; Esophagus, neoplasms

MeSH Terms

Adult
Comparative Study
Esophageal Neoplasms/*diagnosis/radiography
Esophagus/pathology
Female
Human
Leiomyoma/*diagnosis/radiography
Magnetic Resonance Imaging
Male
Middle Age
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Esophageal leiomyoma in a 35-year-old man who had suffered substernal pain for two months.A. Chest radiography reveals a right retrocardiac soft-tissue mass (arrows), with obliteration of the azygoesophageal recess interface.B. Esophagography indicates the presence of a large, smoothly elevated filling defect in the distal esophagus. Also note the extraluminal component of the mass (arrows).C. Enhanced CT scan (10-mm collimation) obtained at the ventricular level shows a homogeneous, iso-attenuated, pear-shaped mass, 75×45 mm in diameter, in the right azygoesophageal recess. Note the presence of gastrograffin-filled esophageal lumen (arrow).D. Enhanced coronal T1-weighted MR image reveals a slightly hyperintense lesion in the azygoesophageal recess area.E. T2-weighted MR image obtained at a level similar to that in C reveals a lesion slightly more hyperintense than chest wall muscle.

• 

  Fig. 2 Esophageal leiomyoma in a 34-year-old man who for one month had complained of abdominal fullness.A. Esophagography demonstrates a crescentic filling defect in the distal esophagus due to the presence of a smoothly elevated mass lesion. Also note the extraluminal component of the mass (arrows).B, C. Enhanced (10-mm collimation) CT scans obtained at the level of the liver dome reveal a circumferential, homogeneous, iso-attenuated mass measuring 60×45 mm in the distal esophagus.

• 

  Fig. 3 Esophageal leiomyoma in a 37-year-old man with mild dysphagia.A. Esophagography shows a soft tissue mass (arrows) surrounding the opacified esophageal lumen. Note that there is mild passage disturbance and mucosal rigidity in the distal esophagus.B. Unenhanced (10-mm collimation) CT scan obtained at another hospital at the level of the liver dome reveals a soft tissue mass measuring 80×40 mm (arrows) surrounding the gas-filled esophageal lumen.

• 

  Fig. 4 Esophageal leiomyoma in a 47-year-old man with no subjective symptoms.A. Thin-section (1-mm collimation) CT scan obtained at the level of the azygos arch shows a homogeneously iso-attenuated lesion (arrows) measuring 26×13 mm (arrows) between the azygos arch and the esophageal lumen, posterior to the carina.B. Enhanced CT scan (7-mm collimation) demonstrates slight homogeneous enhancement.

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