食道平滑肌肉瘤

目的：食道平滑肌肉瘤是一种非常少见的食道恶性肿瘤，旨在探讨食道平滑肌肉瘤患者的一般临床特征、术前诊断及预后。方法：我们报道了本院在2001年12月发现的1例患者的详细资料，另外收集了1965年-1999年间22例英文文献中报告的食道平滑肌肉瘤病例，进行文献复习。结果：食道平滑肌肉瘤发生年龄平均为62.1岁，男：女=1.3：1；肿块生长部位主要在下1/3段食道，占了48％；20例肿块肉眼形态多倍体型为13例（65％），浸润型5例（25％），混合型为2例（10％）；食道平滑肌肉瘤临床表现主要是吞咽困难和体重下降；钡餐、胃镜及活检、CT扫描等检查对术前诊断有帮助，但确诊率不高，18例患者中仅有5例术前确诊，且主要是依靠内镜下活检。本文收集的23例病例中80％（19例）均积极行手术治疗。结论：食道平滑肌肉瘤术前诊断需综合内镜、钡餐、CT及病理检查等；积极行恰当手术治疗的较未行手术治疗的可获得更长的生存时限；女性患者普遍较男性患者生存时限长。

LEIOMYOSARCOMA OF THE ESOPHAGUS:REPORT OF A CASE AND REVIEW OF THE LITERATURE

Objective:Leiomyosarcoma of the esophagus (LMSs) is a very rare neoplasm; The study discussed the clinical features, diagnosis, therapeutic and prognostic implication of the tumor. Method:A case of esophageal leiomyosarcoma found in our hospital in 2001 was described, and we reviewed 22 cases in the English literature from 1965 to 1999.Results:The average age of patients with LMSs was 62.1-year-old; The male/female ratio was 1.3:1.0; The most common location of LMSs was the lower third of the esophagus; The tumor gross growth pattern of 20 patients was polypoid in 13 (65%), infiltration in 5 (25%), and both in 2 (10%). Most patients with LMSs presented with dysphagia and weight loss. Some examinations including Barium swallow, esophagogastroscopy, CT scan and so on were helpful for preoperative diagnosis, but nonspecific. There were only 5 patients whose preoperative diagnosis was LMSs, and they all depended on endoscopic biopsy.Ninteen patients with LMSs (82.6%) were treated surgically. Conclusions:Women with LMSs may have better prognosis than man with LMSs. Surgical treatment probably provides longer survival time.