Successful surgical management of esophageal leiomyoma presenting with gastroesophageal reflux disease symptoms: A case report.

Introduction: Esophageal leiomyoma is the most common benign submucosal mesenchymal tumor of the esophagus, typically asymptomatic but can cause symptoms such as dysphagia, chest pain, or regurgitation when large. Diagnosis is often incidental, confirmed by imaging techniques like computed tomography (CT) and endoscopic ultrasound (EUS), with surgical enucleation being the standard treatment.

Presentation of case: A 28-year-old male presented with a one-year history of persistent epigastric discomfort and gastroesophageal reflux disease (GERD) symptoms unresponsive to proton pump inhibitors. Chest radiograph and CT scan revealed a well-defined submucosal mass in the esophagus. Upper gastrointestinal endoscopy and EUS confirmed the lesion's benign nature. Fine-needle aspiration biopsy showed spindle-shaped cells, confirming esophageal leiomyoma. The patient underwent minimally invasive tumor resection via video-assisted thoracoscopic surgery (VATS), with a smooth postoperative recovery.

Discussion: Esophageal leiomyomas are rare, often asymptomatic, and may present with nonspecific symptoms if large. CT and EUS are key diagnostic tools, and minimally invasive surgery, such as VATS, is the preferred treatment for larger tumors due to shorter recovery times and fewer complications. Early identification and appropriate surgical intervention are crucial for optimal outcomes.

Conclusion: Esophageal leiomyoma should be considered in patients with GERD-like symptoms unresponsive to therapy. Early imaging, endoscopic evaluation, and minimally invasive surgery provide excellent outcomes, with regular follow-up recommended to monitor for recurrence.