Girish D. Bakhshi et al JMSCR Volume 05 Issue 01 January 2017 Page 15630 JMSCR Vol||05||Issue||01||Page 15630-15634||January 2017 Esophageal Leiomyoma Mimicking As Duplication Cyst Authors Girish D. Bakhshi, Rajesh G. Chincholkar, Prakash B. Patodekar, Chaitanaya G. Patil, Rajesh B. Yadav, Amarjeet E. Tandur Department of General Surgery, Grant Government Medical College & Sir J.J. Group Of Hospitals, Mumbai-08 INDIA ABSTRACT Esophageal duplication cyst is a rare entity but well documented. Majority of them are usually diagnosed in childhood but adults are more likely to be symptomatic. Endoscopic ultrasound (EUS) is a diagnostic tool of choice to investigate duplication cyst since it can differentiate between solid and cystic component. However, esophageal duplication cyst, due to its solid content can masquerade as leiomyoma or other benign lesions, but it is exceptionally rare where leiomyoma of esophagus presented as homogenous anechoic lesion mimicking a duplication cyst. We present a case which posed a diagnostic dilemma with EUS appearances closely resembling esophageal duplication cyst, whereas CT scan was suggestive of leiomyoma. However intraoperative findings and histopathological examination of specimen confirmed it to be esophageal leiomyoma. INTRODUCTION Esophageal leiomyomas, though very rare, are most common benign tumours of esophagus [1] . These represent a hyper proliferation of interlacing bundles of smooth muscle cell well demarcated by surrounding tissue or connective tissue capsule [2] . Growing slowly esophageal leiomyomas are usually asymptomatic. most common presenting symptom being dysphagia. Large tumours can cause vague retrosternal discomfort, chest pain, esophageal obstruction, regurgitation and very rarely gastrointestinal bleeding [3] . Diagnosis is with help of esophago- gram, esophagoscopy, computerized tomography (CT) scan, endoscopic ultrasound (EUS) [4] . Enucleation of leiomyoma is safe and effective procedure but whether to operate every patient of leiomyoma remains a controversy. We present a case with diagnostic dilemma as the esophageal lesion was diagnosed as duplication cyst on EUS and leiomyoma on CT scan. CASE HISTORY A 24-years-old male presented with complaints of heartburn and progressive dysphagia to solids and liquids since 3 months. Patient had previous CT report suggestive of eccentric of dimensions 6.4x3.2x6.4 cm with central ulceration communicating with lumen. A few calcific foci within. Focal loss of fat plane with aorta. No lymphadenopathy. GIST being the main differential diagnosis (Fig. 1). www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i1.72