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Cirujano general

Print version ISSN 1405-0099

Abstract

REYES MORALES, Juan Manuel  and  SANCHEZ REYES, Karina. Perforated esophageal leiomyoma. Management in a Third Level Hospital. Cir. gen [online]. 2023, vol.45, n.2, pp.111-115.  Epub Feb 05, 2024. ISSN 1405-0099.  https://doi.org/10.35366/111513.

Introduction:

leiomyomas are the most common benign tumors of the esophagus. Frequently found in the lower and middle third of the esophagus in 56 and 33% respectively. The incidence of presentation is between the third and fifth decade of life. The most frequent symptoms are dysphagia and epigastric pain, up to 50% of patients remain asymptomatic and the tumor is discovered by chance, however, on rare occasions due to the size of the tumor given the areas of intratumoral necrosis, debuting with perforation of the esophagus and mediastinitis. Due to the rarity of this condition, the cases reported in the literature dealing with its surgical management are scarce. The treatment of this pathology can range from simple surgical enucleation to an esophagectomy with or without reconstruction of the digestive tract. The aim of this paper is to report a clinical case of complicated esophageal leiomyoma. reporting our experience in the management of a giant esophageal leiomyoma associated with esophageal perforation and mediastinitis.

Clinical case:

the case of a 54-year-old female patient is presented with signs and symptoms related to mediastinitis secondary to esophageal perforation due to a previously undocumented giant leiomyoma that required emergency surgical management by esophagectomy.

Conclusions:

esophageal leiomyoma is a rare oncological entity that presents several diagnostic and therapeutic challenges. This becomes even more challenging when this pathology presents with a complication, such as mediastinitis. Rapid diagnosis and aggressive and timely treatment are the factors that have the greatest impact on the morbidity of the disease.

Keywords : leiomyoma; mediastinitis; esophagus; surgery.

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