Which is true about esophageal leiomyoma?
Ans. is 'b' i.e., Appears like an ovoid intramural mass with smooth outline on CTo Oesophageal leiomyoma is a benign smooth-muscle neoplasm of the oesophagus. It is the most common benign tumour of the oesophagus.Epidemiologyo It is most frequently presents in young and middle age groups (20-50 years). The overall incidence is around 8-43 per 10,000 autopsy series 4.Clinical presentationo The clinical presentation would often depend on the size of tumour:# small tumours (<5 cm): usually no symptoms# large tumours: may cause dysphagia, regurgitation, oesophageal obstruction,chest pain, cough, bleeding (rare)Pathologyo Like other leiomyomas, they comprise of smooth muscle overgrowth.Locationo They typically involve the mid-to-distal oesophagus.Radiographic featureso Fluoroscopyo On barium swallow, may be seen as a discrete ovoid mass that is well outlined by barium. Its borders form slightly obtuse angles with the oesophageal wall.CTo Findings include:# Ovoid intramural solitary mass with a smooth surface# The presence of calcifications is almost pathognomonic# Narrowing of oesophageal lumen# May displace the oesophagus# Moderate diffuse contrast-enchancement# No signs of invasion of adjacent tissueTreatment and prognosiso The overall prognosis of these benign tumours is excellent. If tumour is small (<5 cm) and asymptomatic treatment is not necessary. Otherwise surgical enucleation is recommended