Thoracoscopic management of a giant horseshoe shaped oesophageal leiomyoma: a case report

Kirthika Arunachalam; Saravanan Sanniyasi; Ponniah Iyyappan; Sri Lakshmi Kanthan Pandian

doi:10.18203/2349-2902.isj20250157

Authors

Kirthika Arunachalam Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
Saravanan Sanniyasi Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
Ponniah Iyyappan Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
Sri Lakshmi Kanthan Pandian Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20250157

Keywords:

Enucleation, Video-assisted thoracoscopic surgery, Giant leiomyoma, Oesophageal tumour

Abstract

Benign oesophageal tumours are considered rare, and most common are leiomyomas with the incidence of 0.005%. Many cases are asymptomatic, up to 15%–50%, and most cases are discovered incidentally. These may vary in size but are typically smaller than 3 cm. Giant esophageal leiomyoma is defined as tumour greater than 10 cm in diameter. Traditionally, open thoracotomy and enucleation have been the primary treatment modalities for oesophageal leiomyoma. However, in recent years, video-assisted thoracoscopic surgery (VATS) enucleation has gained recognition for its proven advantages as a minimally invasive surgical option. Herein we present our experience with patient presenting with cough rather than dysphagia as a main symptom, who was diagnosed to be having giant oesophageal leiomyoma. VATS guided enucleation was accomplished successfully. Size of lesion was 10.0×8.0×7.0 cm. Postoperative recovery was uneventful.

Metrics

Metrics Loading ...

References

Alsinan TA, Robaidi HA, Alkattan KM. A Right Video-Assisted Thoracoscopic Enucleation of a Calcified Oesophageal Leiomyoma: A Case Report. Am J Case Rep. 2020;21:922422. DOI: https://doi.org/10.12659/AJCR.922422

Peters JH, DeMeester TR. Oesophagus and diaphragmatic hernia. In: Brunicardi FC, Andersen KD, Billiar RT, Dunn LD, Hunter GC, Pollock RE, editors. Schwartz's Principles of Surgery. 8th. New York, NY, USA: McGraw-Hill. 2005: 906.

Mutrie CJ, Donahue DM, Wain JC. Oesophageal leiomyoma: a 40-year experience. Ann Thorac Surg. 2005;79(4):1122–5. DOI: https://doi.org/10.1016/j.athoracsur.2004.08.029

Wile RK, Barnes KE, Banks KC, Velotta JB. Video-assisted thoracoscopic surgery (VATS) enucleation of large gastroesophageal junction leiomyoma: A case report. Int J Surg Case Rep. 2022;98:107564. DOI: https://doi.org/10.1016/j.ijscr.2022.107564

Xu H, Li Y, Wang F, Wang W, Zhang L. Video-assisted thoracoscopic surgery for oesophageal leiomyoma: a ten-year single-institution experience. J. Laparoendosc. Adv. Surg. Tech. A. 2018;28(9):1105–8. DOI: https://doi.org/10.1089/lap.2018.0412

Priego P, Lobo E, Alonso N, Gil Olarte MA, Pérez de Oteyza J, Fresneda V. Surgical treatment of oesophageal leiomyoma: an analysis of our experience. Rev Esp Enferm Dig. 2006;98(5):350-8. DOI: https://doi.org/10.4321/S1130-01082006000500005

Mujawar P, Pawar T, Chavan RN. Video Assisted Thoracoscopic Surgical Enucleation of a Giant Oesophageal Leiomyoma Presenting with Persistent Cough. Case Rep Surg. 2016;2:7453259. DOI: https://doi.org/10.1155/2016/7453259

De Giacomo T, Bruschini P, Arcieri S, Ruberto F, Venuta F, Diso D, et al. Partial oesophagectomy for giant leiomyoma of the oesophagus: report of 7 cases. Eur J Cardiothorac Surg. 2015;47(1):143-5. DOI: https://doi.org/10.1093/ejcts/ezu146

Karagülle E, Akkaya D, Türk E, Göktürk HS, Yildirim E, Moray G. Giant leiomyoma of the oesophagus: a case report and review of the literature. Turk J Gastroenterol. 2008;19(3):180-3.

Shin S, Choi YS, Shim YM, Kim HK, Kim K, Kim J. Enucleation of oesophageal submucosal tumours: a single institution's experience. Ann Thorac Surg. 2014;97(2):454-9. DOI: https://doi.org/10.1016/j.athoracsur.2013.10.030

Lewis RB, Mehrotra AK, Rodriguez P, Levine MS. From the radiologic pathology archives: oesophageal neoplasms: radiologic-pathologic correlation. Radiographics. 2013;33(4):1083-108. DOI: https://doi.org/10.1148/rg.334135027

Sun LJ, Chen X, Dai YN, Xu CF, Ji F, Chen LH, et al. Endoscopic Ultrasonography in the Diagnosis and Treatment Strategy Choice of Oesophageal Leiomyoma. Clinics (Sao Paulo). 2017;72(4):197-201. DOI: https://doi.org/10.6061/clinics/2017(04)01

Everitt NJ, Glinatsis M, McMahon MJ. Thoracoscopic enucleation of leiomyoma of the oesophagus. Br J Surg. 1992;79(7):643. DOI: https://doi.org/10.1002/bjs.1800790715

Ha C, Regan J, Cetindag IB, Ali A, Mellinger JD. Benign oesophageal tumours. Surg Clin North Am. 2015;95(3):491-514. DOI: https://doi.org/10.1016/j.suc.2015.02.005