Multiple solitary leiomyomas in the esophagus: report of a case

We herein report our findings for an asymptomatic 65-year-old man presenting with multiple solitary leiomyomas in the esophagus, who was undergoing follow-up for primary aldosteronism with high levels of serum progesterone. Esophageal endoscopy and computed tomography showed multiple submucosal tumors with calcification in the thoracic esophagus. A subtotal esophagectomy was performed because the possibility of malignancy could not be ruled out based on a needle biopsy taken of the specimen. The final resected specimen showed eight solitary, encapsulated nodules between the middle and lower thoracic esophagus. Histopathological examinations showed these nodules to have the typical histological findings of leiomyomas. In addition, staining with antibodies against the progesterone receptor revealed diffuse expression in the nuclei of the leiomyoma cells. Only four cases with more than eight solitary leiomyomas have been reported, including the current case. However, this is the first reported case where primary aldosteronism with elevated serum progesterone levels has been implicated in the pathogenesis of multiple solitary leiomyomas in the esophagus.