A Rare Case of Giant Esophageal Leiomyoma in an Adult Male Presenting With Right Upper Quadrant Pain and Mild Dysphagia

Leiomyomas are the most common benign mesenchymal tumors of the esophagus, and they account for nearly two-thirds of benign esophageal neoplasms. The leiomyomas of the esophagus present with numerous nonspecific symptoms and signs, including dysphagia, shortness of breath, anorexia, weight loss, chronic cough, and bowel obstruction. The patient in this case report presented with moderate to severe right upper quadrant pain and mild dysphagia, which initially prompted evaluation for hepatobiliary pathology. However, the subsequent imaging incidentally showed a tumor surrounding the middle and lower third esophagus. Endoscopic findings identified a large submucosal mass, and the fine needle aspiration (FNA) results confirmed leiomyoma, excluding leiomyosarcoma. Due to the size of the tumor, the patient underwent surgery with muscle-sparing thoracotomy. His recovery was uneventful, and no complications were reported during follow-up visits.