Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Leiomyosarcoma of the esophagus is a rare neoplasm, with only 95 cases having been reported in the literature. Dysphagia is the most commonly noted symptom, however, because of its location in the submucosal layer, the tumor has usually grown to a considerable size by the time this presents. We report herein a case of a 39-year-old man who had no symptoms other than a 7 month history of a cough. After several investigations, the patient underwent resection of the thoracic and abdominal esophagus with lower lobectomy of the right lung through a right and left thoracotomy. The tumor measured 18 x 15 x 8 cm in length and weighed 1,500 g, being the biggest such tumor ever reported. Forty days after the first operation, an extended right hepatic lobectomy of the liver was performed for hepatic metastasis. He was discharged from the hospital 20 days after the second operation and is now doing well. The clinical features and surgical treatment of leiomyosarcoma of the esophagus are discussed herein.
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PMID:A two-stage operation successfully performed for giant leiomyosarcoma of the esophagus with hepatic metastasis. 147 95

The clinical and pathologic characteristics of five patients with esophageal sarcomas are presented, including the only recorded esophageal Triton tumor (malignant schwannoma), the third recorded synovial sarcoma, two patients with carcinosarcoma, and one with leiomyosarcoma. All five patients were males who presented with dysphagia. Three tumors were in the cervical esophagus, and the remaining two were in the distal esophagus. On endoscopic examination, three of the tumors were noted to be polypoid, while the other two were sessile. Two patients presented with disseminated disease, and a third was locally unresectable. These three patients were treated with palliative intent. The remaining two patients underwent surgical excision and postoperative radiation therapy, and are alive and well 6 and 7 years following treatment. This experience suggests that combined modality therapy employing postoperative radiation may be effective in managing these rare lesions.
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PMID:Esophageal sarcomas. 165 95

Leiomyosarcoma of the esophagus is a rare neoplasm. We reported a very rare case of esophageal leiomyosarcoma associated with pulmonary edema by the compression of the left atrium. A 67-year-old man was admitted with a 3-month history of chest pain, exertional dyspnea and dysphagia. Chest X-ray computed tomography showed posterior mediastinal tumor. Esophageogastroscopy and fiberoptic bronchofiberscopy showed no direct invasion of the tumor. By echocardiography, the left atrium was found to be compressed by the tumor and pulmonary hypertension (58/25 mmHg) and increased pulmonary wedge pressure (25 mmHg) was present. Open biopsy specimen demonstrated elongated cells suggestive of sarcoma. At autopsy, the tumor was confirmed to be leiomyosarcoma and to be originated from the lower esophagus.
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PMID:[Leiomyosarcoma of the esophagus associated with pulmonary edema by the compression of the left atrium]. 175 20

A 67-year-old woman was admitted on June 21, 1990 because of an abnormality on chest roentgenogram, a three-month history of palpitations on exertion, and a 2 kg weight loss. Chest roentgenogram revealed a huge mass in the posterior mediastinum. The results of needle aspiration cytology from the mass and celiac angiography were suggestive of leiomyosarcoma of the esophagus. The patient underwent tumor enucleation. The tumor originated from the lower-portion of the thoracic esophagus, measured 23 x 13 x 13 cm, and weighted 1110 g. The tumor was diagnosed as leiomyosarcoma histologically. Esophageal leiomyosarcoma is a very rare malignant tumor. The present case had no history of dysphagia in spite of the large tumor size.
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PMID:[A case of leiomyosarcoma of the esophagus]. 180 90

34 cases with esophageal and cardiac leiomyoma and leiomyosarcoma were treated by surgery from Nov. 1955 to Mar. 1988. Two groups, that of the esophagus and that of the gastric cardia were divided. The patients average age is 34.8-year and 51.8-year respectively. The shortest course of the disease is 15-day and the longest one is 12-year. Dysphagia had been the major symptom. 30 cases had single tumor and 4 cases had multiple lesions. Totally 41 tumors were resected, among which the smallest tumor is 0.6 X 0.4 X 0.3 cm, the largest one is 10 X 9 X 7 cm. Diagnostic criteria to differentiate leiomyoma from leiomyosarcoma and these smooth muscle tumors from other diseases were discussed.
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PMID:[Differential diagnosis and analysis of 34 cases with esophageal and cardiac leiomyoma and leiomyosarcoma]. 237 38

Twelve patients with oesophageal smooth muscle tumour were operated on between 1955 and 1984 in the Department of Thoracic and Cardiovascular Surgery of Helsinki University Central Hospital. Eleven tumours were leiomyomata, the twelfth was a leiomyosarcoma. Dysphagia (83%) and chest or epigastric pains (67%) were the most common symptoms presented. All patients underwent transthoracic removal of the tumour. Complications of the surgery included two cases of postoperative oesophageal fistula; in both instances the lumen of the oesophagus had been entered during the extirpation of the tumour. The surgery was effective in eliminating the most prominent symptom, i.e. dysphagia. However, follow-up examinations 11.1 +/- 6.8 (SD) years later revealed reflux symptoms and endoscopically and histologically verified oesophagitis in seven of the nine (78%) surviving patients. Additionally, two of them had developed Barrett's oesophagus, 10 and 19 years, respectively, after the primary surgery. These two patients underwent subsequent transabdominal antireflux procedures (Nissen fundoplication). We conclude that long-term follow-up of patients who have been treated for benign oesophageal tumour is indicated.
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PMID:Smooth muscle tumours of the oesophagus. 358 96

Between 1970 and 1983, nine cases of tumors of esophageal muscle and connective tissue were treated at the Centre Paul Lamarque. Leiomyoma (LM) (6 cases in this series) represented 0.8% of esophageal tumors reported from among 1,200 patients, while leiomyosarcoma (LMS) (3 cases in this series) were observed in 0.25%. LM is usually detected fortuitously and is asymptomatic, LMS provoking dysphagia of the "foreign body" type contrasting with the "monstrosity" of the radiologic image. Endoscopy and biopsy is justified only when LMS in suspected, since it could interfere with enucleation. Treatment is surgical, by enucleation without mucosal effraction for LM and esophageal resection for LMS. Adjuvant therapy has failed to provide evidence of efficacy.
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PMID:[Muscular tumors of the esophagus. Apropos of 9 cases and review of the literature]. 380 69

Seven cases of leiomyoma and two cases of leiomyosarcoma of the esophagus were presented. Review of the Japanese literature revealed a total of 260 cases of the former and only 35 cases of the latter, including our own cases. They occurred more frequently in males than females, by a ratio of 1.6:1 and 1.8:1, respectively. The patients with leiomyosarcoma distributed in higher age groups. The most frequent symptom was dysphagia in both groups of the cases, but in cases of leiomyosarcoma the incidence was much higher and the duration of the symptom was shorter. About 20% of the patients with leiomyoma were asymptomatic. Although the size of leiomyosarcoma tended to be larger, giant leiomyomas more than 10 cm in diameter were found in 18% of the cases. The lower third of the esophagus was the site of both tumors in over half of the cases, the middle third being the next frequent. The surgical removal by enucleation was the procedure of choice for leiomyoma. However, when either the tumor is densely adherent to the mucosa for considerable length or accidental extensive mucosal tear occurs, esophageal resection is recommended. Postoperative morbidity was minimal and results were generally excellent. On the contrary, esophageal resection including the tumor was indicated for leiomyosarcoma. The long-term results were poor particularly in cases of infiltrating-type lesions, though survival data could not be fully evaluated.
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PMID:[Leiomyoma and leiomyosarcoma of the esophagus: report of 9 cases and review of the Japanese literature]. 667 99

A giant polypoid lesion of the cervical esophagus was discovered on barium swallow in a patient with minimal dysphagia. Endoscopy revealed a whitish, polypoid intraluminal mass with superficial ulcerations and mucosal biopsies, necrotic epithelium plus spindle cells consistent with leiomyoma. At exploration, a leiomyosarcoma with microvascular invasion was excised. The clinical features and value of endoscopic biopsies are reviewed for this and other cases reported in the literature.
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PMID:Endoscopic diagnosis of a giant esophageal leiomyosarcoma. 723 37

Leiomyosarcoma of the esophagus is an uncommon disease of which only 97 cases including the present case have been reported in Japan. We report a case of the tumor which showed multiple hematogenous metastases after surgery. A 73-year-old male was admitted complaining of dysphagia and vomiting. Esophagography and endoscopy revealed a large protruding lesion in the lower esophagus. CT scanning revealed threefold-sized extramural mass. Boring biopsies failed to yield evidence of malignancy. However, we performed surgical treatment because of the uncommon size for a benign tumor. The excised tumor was 11 x 9 x 5 cm in size and was diagnosed histologically as leiomyosarcoma of the esophagus without any nodular involvement. Metastatic tumor in the right rib was found 14 months after the operation. Radiotherapy failed to decrease tumor size but eliminated pain. Bone metastases appeared successively and the patient died 3 years and 4 months after operation. Chemotherapy had no effect. Autopsy revealed metastases to the ribs, vertebrae, sternum, pelvic kidneys and diaphragm, but no local recurrence. There is a great need for the development of effective anti-cancer drugs for leiomyosarcomas, particularly in cases with extensive metastasis, such as presented here.
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PMID:[A report of leiomyosarcoma of the esophagus]. 761 81


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