ENDOSCOPIC ULTRASONOGRAPHY IN THE EVALUATION OF LEIOMYOMA AND EXTRAMUCOSAL CYSTS OF THE ESOPHAGUS

BACKGROUND/AIMS: Leiomyoma is the most common type of benign esophagea l tumor, whereas extramucosal cysts of the esophagus are congenital an omalies frequently asymptomatic in the adult and in most cases detecte d incidentally on chest x-ray. It is worthwhile considering these cond itions together, because they present similar diagnostic and surgical problems. Conventional imaging tests do not lead to a precise diagnosi s. The purpose of this study was to evaluate the use of endoscopic ult rasonography in the diagnosis of, and planning of treatment modalities for, these conditions. METHODOLOGY: Fifteen patients with esophageal leiomyoma and seven patients with extramucosal esophageal cysts were s tudied with endoscopic ultrasonography using an Olympus GF- EU-M3 inst rument with a 7.5-12 MHz echoprobe. In all patients, the results of en doscopic ultrasonography were compared with the histology of the resec ted specimens. RESULTS: The histology of the resected specimens confir med the endosonographic diagnosis in all patients. No malignancy was f ound in any specimen. CONCLUSIONS: Endoscopic ultrasonography is very accurate in visualizing these lesions and differentiating cystic from solid submucosal esophageal masses; in addition, the test can establis h the exact location of the mass in relation to the esophageal wall an d mediastinum. Therefore, endoscopic ultrasonography has a great impac t; in confirming the diagnosis of leiomyoma and extramucosal cysts of the esophagus and facilitates therapeutic decision-making because of i ts capacity to clearly define the size, layer of the origin, and patte rn of the mass.