Multimodality Diagnostic Imaging of Diffuse Esophageal Leiomyomatosis

18F-fluorodeoxyglucose PET/CT in a patient with esophageal and genital leiomyomatosis

Diffuse esophageal leiomyomatosis is a rare benign tumor, which can be associated with leiomyoma in female genital tracts involving the uterus, vagina, and vulva. Alport syndrome, an inherited disorder that includes the kidneys, eyes, and sensorineural hearing loss, is also rarely associated with these multiple leiomyomatosis. In our case, (18)F-fluorodeoxyglucose positron emission tomography/computed tomography was used to distinguish esophageal and genital leiomyomatosis from malignant masses.

Leiomyomatosis of the esophagus: experience over a decade

PURPOSE

To assess the clinical, radiological findings, and treatment strategies in patients with esophageal leiomyomatosis.

BACKGROUND

Esophageal leiomyomatosis is a rare hamartomatous disorder with varied presentation. It is described mostly in children and is associated with Alport's syndrome.

METHODS

A retrospective analysis of three cases managed in the Department of General Surgery at Chandigarh over a period of 10 years.

RESULTS

The study involves three female patients of different generations within the same family with age range of 10-58 years. All presented with dysphagia of 2-7 years duration. Barium swallow revealed a long-segment stricture in two patients. Computed tomography (CT) demonstrated a circumferential mass lesion in the lower esophagus in all the patients. Esophageal resection was carried out in all the patients. All patients made an uneventful recovery.

CONCLUSIONS

Esophageal leiomyomatosis should be suspected in patients with long-standing dysphagia. Barium findings are suggestive but can mimic achalasia. CT scan shows a circumferential esophageal wall thickening. Surgical resection and reconstruction of the digestive passage is the optimal treatment.