Excision of a fluorodeoxyglucose-avid leiomyoma of the esophagus

Leiomyoma is the most common benign esophageal tumor. Positron emission tomography (PET) can be used to preoperatively distinguish leiomyomas from other submucosal tumors such as gastrointestinal stromal tumors. We describe a patient with a large submucosal esophageal tumor demonstrating fluorodeoxy glucose (FDG) avidity on PET. The presence of such increased glucose uptake raised the suspicion for carcinoma or stromal tumor, thus changing the operative strategy. Final histology, however, demonstrated a leiomyoma. This is the first published report of FDG avidity in a leiomyoma of the esophagus.