A Case of Circular Giant Leiomyoma in the Esophagocardiac Junction

Atsushi Adachi, Kazuhisa Tokunoh, Kouji Shimoda, Tetsuji Uchiyama and Takuo Murakami

Department of Surgery, Iwakuni Medical Center Hospital

We report a case of circular giant leiomyoma 13 cm in diameter in the esophagocardiac junction, and review the literature and 14 cases more than 8 cm in diameter in Japan, for which resection was indicated. A 45-year-old male US-resident pilot with hematemesis and melena was admitted to our department because upper GI series revealed a submucosal tumor in the lower esophagus. Endoscopy revealed a dumbbell-shaped elevated submucosal lesion from the lower esophagus to the cardiac region. On abdominal CT and MRI, the tumor showed a well-demarcated homogeneous pattern and no contrast effect. Under right thoracotomy and laparotomy, esophagocardiac resection was conducted with reconstraction by jejunal transfer. The tumor consisted of elastic, hard, and oval solid masses of all sizes, the largest measuring 13.0×8.0×5.0cm. A diagnosis of leiomyoma was made based on histopathological examination. He was discharged on postoperative day 15 and has gone back to work as a pilot.

Key words
leiomyoma in the esophagocardiac junction, surgical therapy, operation method

Reprint requests
Atsushi Adachi Department of surgery, Iwakuni Medical Center Hospital 3-6-12 Muronoki, Iwakuni, 740-0021 JAPAN

Accepted
June 26, 2001

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