| Country and year | Gender and age | Chief complaints | Risk factors | Comorbid diseases | Upper GI Endoscopy | EUS | Other diagnostic modalities [1] | Other diagnostic modalities [2] | Pathology | Location | Treatment |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Japan, 1984 [8] | Male/ 75 | Stenotic sensation in the pharyngeal region | Heavy smoking | Â Not available (NA) | An elevated erosive lesion in the posterior wall of the esophagus | Â NA | Barium esophagogram: a tumorous shadow,5Â cm, middle thoracic esophagus | Â NA | Leiomyoma with overlying SCC | Middle third of the esophagus | Surgery: blunt dissection of the esophagus without thoracotomy, esophagogastroanastomosis |
2 | Japan, 1995 [9] | Male/45 | Dysphagia | Â NA | Â NA | Â NA | Â NA | Â NA | Â NA | Leiomyoma with overlying SCC | Middle third of the esophagus | Esophageal resection and reconstruction |
3 | Japan, 1995 [9] | Male/71 | Not mentioned, referred for treatment of an esophageal tumor | Â NA | Â NA | A mucosal irregularity on the surface of the submucosal tumor | Â NA | Â NA | Â NA | Leiomyoma with overlying SCC | Middle third of esophagus | Esophageal resection and reconstruction |
4 | Japan, 1995 [10] | Male/52 | Asymptomatic | Heavy smoking | Negative | Sessile polypoid lesion at abdominal esophagus | A 9Â mm submucosal tumor with smooth contour, leiomyoma | Barium swallow: as health checkup | Double contrast barium esophagogram: semispherical tumor, 1.5Â cm | Leiomyoma with overlying poorly differentiated SCC | Distal third of the esophagus | Surgical Resection |
5 | Japan, 1997 [11] | Male/61 | Â NA | Â NA | Â NA | Sessile polypoid lesion with a smooth surface at the esophagus | A hypoechoic tumor just below the epithelial layer | Â NA | Â NA | Moderately differentiated SCC on leiomyoma originating from muscularis mucosa | Proximal third of the esophagus | Endoscopic resection by aspiration lumpectomy |
6 | Japan, 2002 [12] | Male/62 | Not mentioned, referred for treatment of an esophageal tumor |  NA |  NA | A protruding lesion, resembling a submucosal tumor, in the proximal third of the esophagus | A hypoechoic tumor confined to the submucosa with a well demarcated, smooth outline | Chromoendoscopy: non-staining |  NA | Moderately differentiated SCC overlying the leiomyoma | Proximal third of the esophagus | Endoscopic mucosal  resection (EMR) |
7 | Japan, 2004 [13] | Male/65 |  NA |  NA |  NA | A sessile polypoid lesion with a smooth surface in the proximal third of the esophagus | A hypoechoic tumor, 13 mm in diameter, located in the submucosa, with clear margins and a smooth contour, with the muscularis propria layer intact | Chromoendoscopy: non- staining |  NA | Leiomyoma with overlying poorly differentiated SCC | Proximal third of the esophagus | subtotal esophagectomy with a three-field (cervical, mediastinal and abdominal) lymph node dissection and esophagogastrostomy  |
8 | Japan, 2006 [2] | Male/71 |  Firstly, presented with a cervical mass |  NA | Malignant lymphoma of the thyroid | A superficial ulcerative tumor [24 mm in diameter] in the lower third of the esophagus, overlying the smaller leiomyoma | Cancer overlaid the smaller leiomyoma and invaded the submucosal layer | Barium swallow Esophagogram: two smoothly rounded defects | Chromoendoscopy: non-staining | Squamous cell carcinoma in situ overlying a leiomyoma, separated multiple leiomyomas | Distal third of the esophagus | Surgery: esophagectomy, gastric pull-up reconstruction, cervical anastomosis via abdominal, left cervical and right thoracotomy incisions |
9 | Japan, 2008 [14] | Male/61 | Mild epigastralgia | Â NA | Â NA | A submucosal tumor with a smooth and mildly red surface mucosa in the proximal third of the esophagus | A hypoechoic lesion originating from the muscularis mucosae with a clear margin | Chromoendoscopy with iodine staining: non-staining area | Â NA | Leiomyoma with overlying SCC | Proximal third of the esophagus | Endoscopic submucosal dissection (ESD) |
10 | Iran, 2009 [15] | Male/47 | Progressive dysphagia and epigastric pain and about 20Â kg weight loss | Â NA | Â NA | A depressed area with uneven and irregular border | Â NA | Â NA | Â NA | Several leiomyomas, the largest of which was covered by malignant SCC | Â NA | Laparotomy, transhiatal esophagectomy, cervical esophagastrostomy (Orringer), and bilateral chest tube insertion |
11 | Japan, 2009 [16] | Male/65 | Asymptomatic | Heavy smoking and alcohol consumption | Negative | An esophageal tumor in the middle thoracic esophagus | Hypoechoic tumor in the muscularis mucosae covered with intraepithelial layer indicative of leiomyoma | Chromoendoscopy with iodine staining: non-staining area | Magnifying endoscopy with narrow band imaging (NBI): dilated and elongated intrapapillary capillary loop (IPCL), indicated intraepithelial carcinoma | Leiomyoma with overlying SCC | Middle third of the esophagus | Â ESD |
12 | Turkey 2012 [4] | Male/44 | Weight loss and dysphagia for two month | Negative | Negative | A tumoral mass with a partially irregular surface in the distal third of the esophagus | Â NA | CT scan of the thorax and abdomen: minimally diffuse esophageal wall enlargement in a 5Â cm segment of the distal esophagus with no lymph node involvement or distant metastasis | Â NA | SCC infiltrated to the submucosa and two separated leiomyoma along with five reactive and three metastatic lymph nodules | Distal third of the esophagus | Distal esophagectomy and an esophagogastrostomy together with a laparotomy and thoracotomy (Ivor-Lewis approach) |
13 | Japan, 2013 [17] | Female/75 | Esophageal tumor at health checkup |  NA | Hyperglycemia and osteoporosis | A submucosal tumor, measuring 5 × 4 mm in diameter, 20 cm from the incisors |  NA |  NA |  NA | Coexistence of esophageal SCC in situ (high-grade intraepithelial neoplasia) overlying leiomyoma |  20cm from the incisors (proximal third of the esophagus) |  EMR |
14 | South Korea, 2014 [19] | Male/53 | Esophageal tumor at health checkup | Â NA | Â NA | An elevated mass, 1.8Â cm in diameter, with irregular central small erosion in the upper thoracic esophagus | Â NA | Chromoendoscopy with iodine staining: non-staining area | Â NA | Squamous cell carcinoma in situ overlying submucosal leiomyoma | Proximal third of the esophagus | Subtotal esophagectomy |
15 | South Korea, 2015 [1] | Male/66 | Esophageal tumor at health checkup |  NA |  NA | A protruding mass that measured 1 × 1 cm in diameter and was located 25 cm from the upper incisors | A hypoechoic and homogeneous lesion that originated from the muscularis mucosa (MM) below the epithelial layer | Chromoendoscopy with iodine staining: non-staining area |  NA | Squamous cell carcinoma in situ overlying submucosal leiomyoma | Middle third of the esophagus | ESD |
16 | Iran, 2020 (current study) | Female/41 | Progressive dysphagia and significant weight loss for the preceding 6 months | Negative | Negative | A large fungating and ulcerative mass, middle and lower third of esophagus, 25–33 cm from the upper incisors |  NA | Chest CT scan: a 29*18 mm soft tissue fullness at middle to distal esophagus, suggestive for tumoral lesion |  NA | Multiple leiomyomas, SCC overlying a leiomyoma | Middle and distal third of the esophagus | Extended thoracotomy, esophagectomy, gastric pull-up, pyloroplasty, cervical esophagostomy (Orringer) |