·         Most common benign tumor of esophagus

o       Leiomyomas are also the most common benign tumor of the small bowel but are not common in the colon

·         Usually asymptomatic

·         May produce dysphagia or hematemesis if large

·         Typically occurs in young males

·         Found most often in distal third of esophagus

·         Usually solitary, but may be multiple (3%)

·         Imaging findings

o       Smooth, sharply-marginated mass

o       Well-defined, intramural (wall) mass lesion that typically intersects wall at 90 degree angle when viewed in profile

o       As a wall lesion, it may narrow the lumen in one plane and widen it in the orthogonal view (a plane at 90 degrees to the original)

o       May have coarse calcifications (only calcifying esophageal tumor)

o       Rarely ulcerates

 

Leiomyoma of the esophagus. Large filling defect with sharply-marginated border is seen in distal esophagus.
Contrast seen within the lesion did represent an irregular ulcer in the mass. Leiomyomas are the most
common benign esophageal tumors.
For a larger photo of the same image, click here

 

 

·         May demonstrate diffuse contrast-enhancement on CT

·         DDx: Neurofibromas, hemangiomas and lipomas, all uncommon