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Pathology of Leiomyoma

of the Esophagus

Dr Sampurna Roy MD


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Esophageal leiomyomas, although rare, are the most common benign intramural tumours of the esophagus.

They represent 10% of all gastrointestinal leiomyomas.

Visit: Gastrointestinal Stromal Tumour

Age- Usually occurs in middle aged and elderly patients, presenting  with dysphagia and heartburn.

  Distal third of esophagus. Tiny  'seedling leiomyoma'  is a common incidental finding at  the cardioesophageal junction,in autopsy cases.


The tumour arises from the smooth muscle coat of the esophagus as a sessile or pedunculated ,polypoidal, exophytic intraluminal solid, grayish white whorled cut surface.

Focal calcification is sometimes noted.

Secondary ulceration may be present. 
Rarely the tumour presents as a lobulated extramural mediastinal mass.

Microscopic features- 

The tumour, like in other sites, is composed of interlacing bundles of smooth muscle cells.

The cells are smooth muscle actin and desmin positive.

Features indicating malignancy-

- Tumour size more than 5cm in diameter
- Mitosis more 5 per 10 HPF
- Presence of necrosis and haemorrhage


Further reading

Esophageal leiomyoma: a 40-year experience.

Giant leiomyoma of the esophagus.

Leiomyoma of the esophagus.

Leiomyomas of the lower third of the esophagus. Value of transhiatal enucleation.

Leiomyoma of the esophagus.


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Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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