This report presents the case of a 16-year-old girl with progressive dysphagia and weight loss over 6 months. Initial examinations, laboratory findings, and upper endoscopy were unremarkable. High-resolution esophageal manometry was suspicious of achalasia, but subsequent imaging revealed the presence of a non-homogeneous mass in the esophageal wall, identified as esophageal leiomyoma through histopathological and immunohistochemical analyses. Despite the rarity of this tumor in adolescents, our findings emphasize the importance of considering esophageal leiomyoma in the differential diagnoses of intramural esophageal lesions. The patient was advised of surgical treatment, which she and her family refused. This case underscores the need for accurate tissue diagnosis via endoscopic ultrasonography (EUS)-guided biopsies to guide treatment decisions, especially in young patients presenting with significant esophageal symptoms.
Saeian et al. (Fri,) studied this question.