Opinion statement
Esophageal leiomyomas are often discovered incidentally when a barium swallow or endoscopic examination performed for unrelated reasons reveals a smooth, submucosal mass in the esophagus. Although surgical removal and histologic examination are required to prove the diagnosis, a diagnosis of esophageal leiomyoma can be established with reasonable certainty by a careful clinical evaluation that includes endoscopy, endoscopic ultrasonography (EUS), and CT scan. If these tests reveal any feature that suggests malignancy, or if the tumor is causing symptoms, the lesion should be removed surgically, provided there is no severe co-morbidity or evidence of metastatic disease. If the imaging studies are typical of benign leiomyoma and the patient has no symptoms, therapy should be individualized. The limited data available on the natural history of esophageal leiomyomas suggests that the tumors grow slowly and that malignant transformation is extremely uncommon.
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Spechler, S.J., Waxman, I. Esophageal leiomyomas. Curr Treat Options Gastro 3, 71–76 (2000). https://doi.org/10.1007/s11938-000-0063-2
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DOI: https://doi.org/10.1007/s11938-000-0063-2