Upper Gastrointestinal Surgery Unit

LEIOMYOMA

Leiomyoma is a tumor that takes origin in the muscle layers of the esophageal or gastric wall.

Esophageal leiomyoma may be associated with a motility disorder that may account for the existence of dysphagia.

As a consequence, only large tumors require an operation that usually consists of an extramucosal excision of the mass by either thoracoscopy or conventional thoracotomy. A second reason for removing a large esophageal leiomyoma is that some of these tumors may be malignant (leiomyosarcoma).

Small esophageal leiomyomas must be followed up rather than removed immediately, especially when a motility disorder is present in the esophageal body. Indeed, removal of the small tumor by extramucosal excision usually is poorly effective on the symptom of dysphagia because the latter is much more related to the underlying motility disorder than to the presence of a small mass within the esophageal wall.

Leiomyoma of the stomach exposes the patient to the risk of acute bleeding so that this type of tumor must be removed as soon as it has been detected on endoscopy.
Excision of a gastric wall patch containing the mass usually is feasible. However, tumors located close to the gastric inlet or outlet require a classic gastrectomy.