Esophageal leiomyoma in children: two case reports and review of the literature.
Leiomyoma of the esophagus is not uncommon in the adult population but is rarely seen in children; only 20 cases have been reported in the pediatric population. In this paper we describe two cases of esophageal leiomyoma in female patients aged 6 and 13 years and review previous reports. Several differences were noted between the pediatric and adult population. The mean age in children is 14 years (range, 4 to 20 years). Leiomyoma appears 1.71 times more often in females than in males. Localized lesions are found in only 9%, whereas the diffuse form predominates in 91%. The entire esophagus may be involved 35% of the time, and encroachment on the cardia or upper stomach occurs in 70%. Leiomyomas associated with familial syndromes (familial leiomyoma and Alport's syndrome) occur in 22% of the cases. Major symptoms include dysphagia (86%), dyspnea (36%), vomiting (27%), retrosternal pain (27%), and coughing (22%). The initial diagnosis following contrast studies is most often achalasia. The diagnosis of leiomyoma is made only with subsequent endoscopy. Enucleation was performed in only 11% of the cases; surgical resection (including part of the stomach) was necessary in 78% with a 21% postoperative mortality. Esophageal leiomyoma should be considered in the differential diagnosis of mediastinal masses and esophageal obstruction. Accurate preoperative diagnosis is desirable in order to plan proper surgical treatment.
Bourque
M D
MD
Department of Surgery, Hôpital Ste-Justine, Montreal, Quebec, Canada.
Spigland
N
N
Bensoussan
A L
AL
Collin
P P
PP
Saguem
M H
MH
Brochu
P
P
Blanchard
H
H
Reinberg
O
O
D000293:Adolescent; D002648:Child; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000601:surgery*