Are biopsies during endoscopic ultrasonography necessary for a suspected esophageal leiomyoma? Is laparoscopy always feasible?

Abstract

The present letter to the editor is related to the work entitled “Large leiomyoma of lower esophagus diagnosed by endoscopic ultrasonography-fine needle aspiration: A case report.” Although endoscopic ultrasonography seems necessary in a suspected leiomyoma of the esophagus, the performance of biopsies via fine needle aspiration is controversial as it increases the risk of complications such as bleeding, infection, and intraoperative perforations. Laparoscopy is the best treatment strategy for small tumors. Laparotomy with tumor enucleation or esophageal resection can be considered in large leiomyomas.

Keywords: Esophageal Leiomyoma; Endoscopic ultrasonography; Biopsy; Surgical resection

Core Tip: Endoscopic ultrasonography seems necessary in a suspected leiomyoma of the esophagus. However, the performance of biopsies via fine needle aspiration is controversial. It increases the risk of complications such as bleeding, infection, and intraoperative perforations. Moreover, there is a possibility of an inconclusive biopsy due to inadequate material. Laparoscopy is the best treatment option for small tumors. Laparotomy with tumor enucleation or esophageal resection can be considered in large leiomyomas.