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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 2 0 0 1年 1 2月发现的 1例患者的详细资料 ,另外收集了 1 965年～1 999年间 2 2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% ;2 0例肿块肉眼形态多倍体型为1 3例 (65 % ) ,浸润型 5例 (2 5 % ) ,混合型为 2例 (1 0 % ) ;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 ,1 8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 2 3例病例中 80 % (1 9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
Objective : Esophageal leiomyosarcoma is a very rare type of esophageal malignancy. It aims to investigate the general clinical features, preoperative diagnosis and prognosis of patients with esophageal leiomyosarcoma. METHODS: We reported detailed data on one patient who was found in our hospital in January and February of 2001. In addition, we collected cases of esophageal leiomyosarcoma that were reported in 22 English articles between 1965 and 1999. review. RESULTS: The average age of esophageal leiomyosarcoma was 62.1 years old; male: female = 1.3:1; the site of mass growth was mainly in the lower 1/3 of the esophagus, which accounted for 48%; 20 cases of the mass were polymorphous. Thirty-three patients (65 %) were infiltrated in 5 patients (2 5 %) and mixed patients were in 2 patients (1 0 %). The clinical manifestations of esophageal leiomyosarcoma were dysphagia and weight loss; barium meal, gastroscopy, biopsy, and CT scan. Such tests are helpful for preoperative diagnosis, but the diagnosis rate is not high. Of the 18 patients, only 5 were diagnosed before surgery and they mainly depended on endoscopic biopsy. Of the 23 cases collected in this article, 80% (19 cases) were actively treated. Conclusion: Preoperative diagnosis of esophageal leiomyosarcoma requires endoscopy, barium meal, CT and pathological examination. Proactive and appropriate surgical treatment can achieve a longer survival time than surgical treatment. Female patients generally have a longer survival time than male patients.