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Table 2 Summarized previous published reports on leiomyoma with overlying SCC

From: Esophageal leiomyoma and simultaneous overlying squamous cell carcinoma: a case report and review of the literature

 

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

 Not available (NA)

An elevated erosive lesion in the posterior wall of the esophagus

 NA

Barium esophagogram: a tumorous shadow,5 cm, middle thoracic esophagus

 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

 NA

 NA

 NA

 NA

 NA

 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

 NA

 NA

A mucosal irregularity on the surface of the submucosal tumor

 NA

 NA

 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 9 mm submucosal tumor with smooth contour, leiomyoma

Barium swallow: as health checkup

Double contrast barium esophagogram: semispherical tumor, 1.5 cm

Leiomyoma with overlying poorly differentiated SCC

Distal third of the esophagus

Surgical Resection

5

Japan, 1997 [11]

Male/61

 NA

 NA

 NA

Sessile polypoid lesion with a smooth surface at the esophagus

A hypoechoic tumor just below the epithelial layer

 NA

 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

 NA

 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

 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 20 kg weight loss

 NA

 NA

A depressed area with uneven and irregular border

 NA

 NA

 NA

Several leiomyomas, the largest of which was covered by malignant SCC

 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

 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

 NA

CT scan of the thorax and abdomen: minimally diffuse esophageal wall enlargement

in a 5 cm segment of the distal esophagus with no lymph node involvement or distant metastasis

 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

 NA

 NA

An elevated mass, 1.8 cm in diameter, with irregular central small erosion in the upper thoracic esophagus

 NA

Chromoendoscopy with iodine staining: non-staining area

 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)