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男,39岁。因渐进性吞咽梗阻2年半。X线吞钡造影:食管下段管腔明显增宽,左后壁有一约8×5cm块影向腔内突出,边缘整齐呈分叶状。纤维食管镜检查:食管下段左后壁有一球状隆起,基底宽广,表面血管纹理清晰。以食管平滑肌瘤收治。体检和常规化验均正常。术中发现肿瘤位于食管肌层,质硬,光滑,无包膜,约7×4×3cm,食管与周围组织无粘连,完整摘除肿瘤。术后恢复良好,进食顺利,随访2年无复发。病理检查大体呈长圆结节分叶状肿块,质地均匀,中等硬度,灰黄和灰白色相间,切面平整。
Male, 39 years old. Progressive swallowing obstruction for 2 and a half years. X-ray angiography: The lumen of the lower esophagus was significantly widened. There was an approximately 8×5 cm block on the left posterior wall that protruded into the cavity with a neat rim. Fiber esophagoscopy: There is a spherical bulge in the left posterior wall of the lower esophagus. The base is wide and the surface veins are clear. Treated with esophageal leiomyoma. Physical examination and routine tests are normal. The tumor was found in the esophageal muscle during operation, and it was hard, smooth, and non-enveloped. It was approximately 7×4×3 cm. No adhesion was observed between the esophagus and the surrounding tissue. The tumor was completely removed. Postoperative recovery was good, eating was successful, and there was no recurrence after 2 years of follow-up. The pathological examination was generally a lobular mass with long rounded nodules. The texture was uniform, medium hardness, grayish yellow and grayish white, and the cut surface was smooth.