CTICasesEsophageal Leiomyoma
Imaging findings
Chest radiographs and CT demonstrate a large, well-circumscribed, and homogeneous retrocardiac mass in the middle mediastinum, showing focal calcifications, causing mass effect on the distal esophagus. The mass is distinct from the stomach and is not a hiatal hernia. Immunohistochemistry is positive for smooth muscle markers and CD117-positive pacemaker cells (interstitial cells of Cajal).
Key takeaways
Leiomyomas are the most common benign tumors of the esophagus, typically arising from the smooth muscle cells of the muscularis propria or muscularis mucosae in the distal two-thirds of the esophagus. Radiographically, they present as smooth, mediastinal masses that can mimic hiatal hernias. They can be associated with interstitial cells of Cajal, showing specific immunohistochemical staining.
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