LEIOMYOSARCOMA OF THE ESOPHAGUS - RADIOGRAPHIC FINDINGS IN 10 PATIENTS

OBJECTIVE. Leiomyosarcomas of the esophagus are rare malignant smooth- muscle tumors that have been described only anecdotally in the radiolo gy literature. The objective of this study was to evaluate the clinica l and radiographic findings of this unusual lesion. MATERIALS AND METH ODS. A search of the radiology archives of the Armed Forces Institute of Pathology revealed 10 cases of esophageal leiomyosarcomas. Clinical and radiographic findings were reviewed retrospectively. RESULTS. All but one patient presented with dysphagia. The average duration of the dysphagia was 6.7 months, but five patients had dysphagia for 3 or fe wer months, Frontal chest radiographs revealed a mediastinal mass in f ive patients. Barium studies revealed intramural lesions in six patien ts, intraluminal lesions in two, and infiltrative lesions in two. The intramural lesions all had large exophytic components, and three conta ined ulceration or tracking. One of the intraluminal lesions appeared as a polypoid expansile mass acid the other, as a smooth expansile sau sage-shaped mass mimicking a fibrovascular polyp, CT revealed a mass i nvolving the esophagus in five patients; three of these patients had h eterogeneous lesions containing large exophytic components, central ar eas of low density, and extraluminal gas or contrast material within t he tumor, In two patients, MR imaging revealed large masses that were isointense with skeletal muscle on T1-weighted images and hyperintense on T2-weighted images. CONCLUSION. Our experience suggests that esoph ageal leiomyosarcomas have radiographic findings similar to those of l eiomyosarcomas elsewhere in the gastrointestinal tract, Esophageal lei omyosarcomas have a better prognosis than squamous cell carcinomas and are often amenable to surgical cure.