Esophageal leiomyomas are rare, benign (non-cancerous) growths in the esophagus. In fact, esophageal leiomyomas are so rare, that they constitute less than 0.6 percent of all abnormal growths in the esophagus worldwide. Most esophageal leiomyomas are found accidentally when patients are undergoing testing for other conditions of the esophagus, like dysphagia (difficulty swallowing).

Symptoms of Esophageal Leiomyoma

Esophageal leiomyomas that are small, or less than two inches in diameter, typically do not cause any symptoms. However, larger leiomyomas can cause:

  • Dysphagia (difficulty swallowing)
  • Chest pain that is felt behind the breastbone
  • Obstruction of the esophagus
  • Regurgitation

Causes of Esophageal Leiomyoma

The reason why esophageal leiomyomas develop is unknown. Scientists also have not identified a trend in whether these growths occur more often in certain ethnicities or if they are more prevalent in men or in women.

What to Expect at Your Appointment

Typically, esophageal leiomyomas are detected while conducting diagnostic testing for other conditions of the esophagus. If your doctor suspects that there is an abnormal growth in your esophagus, he/she may prescribe the following tests:

  • Barium swallow test: Esophageal leiomyomas can be detected using a barium swallow test. During a barium swallow test, patients will be asked to drink a liquid containing barium sulfate before taking x-ray images. This liquid coats the esophagus and allows physicians to see the shape of abnormal growths in the esophagus.
  • Esophagoscopy: An esophagoscopy may be used to confirm the presence of an abnormal growth in the esophagus. During this procedure, a thin, flexible tube called an endoscope is inserted into the mouth and through to the esophagus. The endoscope produces images of the esophagus, which are displayed on a screen.
  • Esophageal ultrasound: Esophageal ultrasound is a useful procedure for diagnosing an esophageal leiomyoma and for determining appropriate treatment decisions. During this procedure, a special kind of endoscope that emits ultrasound waves is inserted through the mouth to the esophagus. The ultrasound produces detailed images of the growth and allows your doctor to see whether the growth is impeding deeper layers of the esophagus.

Non-Surgical Treatments for Esophageal Leiomyoma

Esophageal leiomyomas that are smaller than two inches can be monitored periodically using the barium swallow test. This is because they often cause no symptoms and have a very slow growth rate. It is recommended that larger leiomyomas, or growths larger than two inches, be surgically removed.

Surgical Treatment for Esophageal Leiomyoma and Post-Treatment

Surgical resection of larger, symptomatic esophageal leiomyomas eliminates symptoms and allows the growth to be tested and characterized as benign or malignant. Esophageal leiomyomas can be removed using the following thoracic surgical techniques:

  • Open surgery: An open surgical technique uses one long incision to open the esophagus and access the leiomyoma in the esophagus.
  • Video-assisted thoracoscopic surgery (VATS): Video-assisted thoracoscopic surgery, also called VATS, is a minimally invasive surgery that uses several tiny incisions in the chest. Through these incisions, the surgeon introduces special surgical instruments. One instrument is equipped with a camera and a light on the end. This allows the surgeon to see inside the chest cavity and the esophagus while performing the surgery.

The type of surgery recommended will depend on the location of the leiomyoma, its size, and the overall health of the patient. After the surgical resection procedure, the patient will be required to stay in the recovery unit for monitoring.

Make an Appointment

For an appointment with a specialist, call 202-877-3627.