Report of Two Cases of Esophageal Leiomyosarcoma

Akifumi Mori, Masayuki Higashino, Harushi Ohsugi, Noriaki Maekawa, Taigho Tokuhara, Shinya Tanimura, Yohsuke Fukunaga, Hiroaki Kinoshita

Second Department of Surgery, Osaka City University Medical School

Esophageal leiomyosarcoma is a rare disease. Only 52 cases have been reported, including our two cases. Histological diagnosis of esophageal leiomyosarcama is rarely made preoperatively. In one of our cases histological diagnosis was obtained because of intramural growth and ulcer formation of the lesion, but in the other case, it could not be made because the lesion was covered with normal mucosa. Endoscopic ultrasonograpy revealed the proper location of the lesion and the presence of necrosis in the lesion. Therefore, it was reported that esophageal leiomyoma showed hypovascularity. Angiography showed hypervascularity of the lesion in the two cases. Resection of the lower half of the esophagus bearing the lesion and reconstruction using a gastric roll was performed in these cases. Pathological diagnosis of esophageal leiomyosarcoma was obtained because of the interlacing bundles of spindle cells (tumor cells), high cellularity and the presence of more than 5 mitoses in one visual field. In addition, upper GI tract examination, endoscopy, CT scanning, endoscopic ultrasonography and angiography were found to be informative in obtaining proper diagnosis of esophageal leiomyosarcoma.

Key words
esophageal leiomyosarcoma, endoscopic ultrasonogram of esophageal leiomyosarcoma

Reprint requests
Akifumi Mori Second Department of Surgery, Osaka City University Medical School
1-5-7, Asahi-machi, Abeno-ku, Osaka, 545 JAPAN

Accepted
September 9, 1992

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