Robot-Assisted Esophageal Leiomyosarcoma Resection

Arámbulo RH1*, Ya-Lyn AN2, Hillegersberg RV2 and Ruurda J2

1Department of General and Digestive Surgery, Bellvitge University Hospital, Spain
2Department of Surgical Oncology - Upper Gastrointestinal Surgery, UMC Utrecht, Netherlands

^*Correspondance to: Rodrigo Hermoza Arámbulo 

 PDF  Full Text DOI: 10.25107/2474-1647.3644

Abstract

Background: Esophageal leiomyosarcomas are rare, they represent approximately 0.1% to 0.5% of malignant esophageal tumors and were described for the first time in 1902, since then only a few cases have been reported. Robot-assisted thoracoscopic surgery is a relatively new technique for treatment of esophageal lesions. We report a case of robot-assisted thoracoscopic resection of an esophageal leiomyosarcoma. Case Report: A 64-year-old man with a past medical history of smoking initially presented to our unit with a 10-months history of retrosternal chest pain. The pain had to be controlled with opiods. However, symptoms persisted and a surveillance Computerized Tomography performed 6 months later demonstrated a new 2.1 cm left paraesophageal mass without thoracic lymphadenopathy and close contact with the thoracic aorta. Further investigations performed included a Positron Emission Tomography-Computerized Tomography, and an Endoscopic Ultrasonography (EUS). EUS biopsies revealed the mass to be a leiomyosarcoma. The patient subsequently underwent robot-assisted left sided thoracoscopic resection. The tumor was located in the mid-thorax arising from the esophagus with a pedicle to the esophageal wall and it was resected en bloc along with the surrounding pleura. There was no invasion into the aorta or pulmonary vein. The patient made a full recovery and was sent home 2 days after the surgery. Pathology report described a Grade 2 Sarcoma with a diameter of 4.0 cm, with free resection margins. Conclusion: The robot-assisted minimally invasive thoracoscopic approach should be considered a feasible option for resection of esophageal leiomyosarcoma due to its benefits on dissection in a limited space, improved precision and complications reduction.

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Cite the article

Arámbulo RH, Ya-Lyn AN, Hillegersberg RV, Ruurda J. Robot-Assisted Esophageal Leiomyosarcoma Resection. Clin Surg. 2023; 8: 3644.