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食管平滑肌肉瘤罕见,其发生率占食管恶性肿瘤的0.5％～1％。报告一例如下。患者女,37岁,因进行性咽下困难7个月,只能进流质10天,于1988年9月29日入院。查体;轻度贫血,其他一般情况尚可。钡餐透视:食管下段见有9cm不规则狭窄区,粘膜中断破坏,管壁僵硬,病变以上食管明显扩张。10月8日在气管内插管静脉复合麻醉下经左胸行食管癌切除,食管胃主动脉弓上吻合术。肿块位于食管下段,呈梭形,长约11cm,最大直径约6cm,侵及食管外膜,与纵隔胸膜粘连,无肿大淋巴结。手术经过顺利,术后恢复良好。病理诊断为食管平滑肌肉瘤。讨论食管平滑肌肉瘤的临床表现与食管癌相似,但胸骨后疼痛常较轻微,偶见有剧痛或锐痛者;夜间疼痛可呈阵发性,常影响入眠。疼痛
Esophageal leiomyosarcoma is rare and its incidence accounts for 0.5% to 1% of esophageal malignancies. One example of the report is as follows. The patient, 37 years old, was admitted to the hospital on September 29, 1988, because she had difficulty swallowing for 7 months and was only admitted to fluids for 10 days. Physical examination; mild anemia, other general conditions are acceptable. Barium meal perspective: the lower esophagus see irregular 9cm narrow area, mucosal disruption disruption, rigid wall, esophageal lesions above the obvious expansion. On October 8th, under the combined endotracheal intubation and intravenous anesthesia, left esophagectomy and esophagogastric aortic arch anastomosis were performed. The mass was located in the lower part of the esophagus and was fusiform. It was about 11cm long and had a maximum diameter of about 6cm. It invaded the outer membrane of the esophagus and adhered to the mediastinal pleura without enlarged lymph nodes. The operation went well and recovered well after surgery. Pathological diagnosis of esophageal leiomyosarcoma. Discussion The clinical manifestations of esophageal leiomyosarcoma are similar to those of esophageal cancer. However, post-sternal pain is often mild. Occasionally, there are severe or sharp pains; nocturnal pain can be paroxysmal and often affect sleep. pain