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Weekly Chest CasesArchive of Old Cases

Case No : 642 Date 2010-02-14

  • Courtesy of Kun Young Lim, MD, Hyae Young Kim, MD, Soo Hyun Lee, MD / National Cancer Center, Korea.
  • Age/Sex 19 / F
  • Chief ComplaintIncidentally found mass in abdomen USG
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Esophageal leiomyoma
Radiologic Findings
Contrast enhanced CT scans show a circumferential mass in the distal esophagus just above the gastroesophageal junction. The mass shows homogenous and iso attenuation, compared to back muscles. CT attenuation of the mass was 62HU (mean).
Brief Review
Esophageal leiomyoma is relatively rare and it is the most common benign tumor in esophagus. Approximately 90 percent of esophageal leiomyomas occur in patients between 20 and 60 years old and approximately 60% of leiomyomas occur in the lower third of the esophagus. Esophageal leiomyomas grow slowly and usually produce intermittent, insidiously progressive symptoms. Occasionally, they encircle the esophagus in a serpentine or U-shaped fashion and cause obstructive symptoms. It manifests as a smoothly marginated, round or lobulated mass with homogenous attenuation projecting to one or both sides of the mediastinum along the course of the esophagus. According to the report, tumor attenuation was homogeneously low or iso and, characteristically, the same even when contrast medium was administered. These findings of homogeneity and slight enhancement are presumed to be due to the relatively small vascular supply of the esophageal tumors.

References
1. Seremetis MG, Lyons WS, Deguzman VC, Peabody JW. Leiomyomata of the esophagus. Cancer 1976;38:2166-2175
2. Gallinger S, Steinhardt MI, Goldger M. Giant leiomyoma of the esophagus. Am J Gastroenterol. 1983;78:708�711
3. Yang PS, Lee KS, Lee SJ, Kim TS, Choo IW, Shim YM, Kim K, Kim Y. Esophageal leiomyoma: radiologic findings in 12 patients. Korean J Radiol. 2001;2:132-137
Keywords
Esophagus, Benign tumor,

No. of Applicants : 81

▶ Correct Answer : 17/81,  21.0%
  • - Univ. of Miami/Jackson Memorial , United States mantosh rattan
  • - Osaka University , Japan Osamu Honda
  • - CHUV , Switzerland ANNE-SOPHIE KNOEPFLI
  • - seoul national university hospital , Korea (South) Ijin Joo
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - Hotel-Dieu Montreal , Canada nicolas gautier
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - DRPGMC TANDA , India maneesh verma
  • - Vitalife Clinics , Pune , India. , India Rahul Deshmukh
  • - CHU Nancy , France, Metropolitan Guillaume LUX
  • - PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - All India Institute of medical sciences , India Justin Moses
  • - CH de la C�te Basque , France Paul ARDILOUZE
  • - IRSA rochefort , France Viviane Pages
  • - Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
  • - Yashoda Superspeciality hospital , India Pravin Mahadevappa
  • - Seoul asan medical center , Korea (South) Gil-Sun Hong
▶ Correct Answer as Differential Diagnosis : 19/81,  23.5%
  • - CHRU lille , France manuel toledano
  • - McGill University , Canada Ben Smith
  • - All India Institute of Medical Sciences , India Jitesh Ahuja
  • - aarthi scans , India abirami mahadevan
  • - SoonChunHyang univ. hospital , Korea (South) Kim Jae Hyun
  • - care hospital , India Chary D
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - radiologist, aditya imaging centre , India vivek patel
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Osaka University , Japan Hiromitsu Sumikawa
  • - Goa Medical College , India Paresh Desai
  • - Song-do Hospital , Korea (South) Ji-young Yun
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - IRSA , France jean-luc BIGOT
  • - Uzunkopru Devlet Hastanesi , Turkey Armagan Sarac
  • - NASA SCANS , India RAKESH BHATIA
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
▶ Semi-Correct Answer : 3/81,  3.7%
  • - hospital , Saudi Arabia marwan alchami
  • - DRRPGMC KANGRA AT TANDA , India dinesh sood
  • - KKUH , Slovenia raees ahmed
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