Leiomyoma is the most common submucosal tumor of the esophagus, and accurate preoperative diagnosis is difficult. We report herein on two resected cases of esophageal leiomyoma preoperatively diagnosed accurately with endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB). The first patient, a 34-year-old man, had complained of dysphagia. Following EUS-FNAB, the pathological diagnosis was leiomyoma. Esophagectomy and reconstruction with a gastric tube were performed because the tumor had almost completely encircled the esophageal wall. The second patient, a 60-year-old woman, had complained of dysphagia. Following EUS-FNAB, the pathological diagnosis was leiomyoma. Enucleation of the tumor was performed because the tumor was not located in the entire circumference of the esophageal wall. The postoperative course of both patients was uneventful, and the final pathological diagnosis of each case was leiomyoma. We conclude that EUS-FNAB is a useful method for diagnosing esophageal submucosal tumors and for selecting an appropriate surgical procedure.
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