Misdiagnosis of esophageal leiomyoma combined with adrenal cortical adenoma as esophageal cancer with adrenal metastasis by fluorine-18-fluorodeoxyglucose positron emission tomography: A case report

Leiomyoma is a benign muscular abnormality that commonly occurs in the middle and distal third of the esophagus, leading to thickening of the esophageal wall and subsequent esophageal luminal narrowing. Notably, esophageal leiomyoma often does not show increased 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET). The present study described a case of esophageal leiomyoma combined with adrenal adenoma. Results of the PET-computed tomography analysis revealed that FDG metabolism was increased in the lower segment of the esophagus and the left adrenal gland, with maximum standardized uptake values of 6.5 and 4.1, respectively. Therefore, initially, the patient was diagnosed with an esophageal malignant tumor with left adrenal metastasis. Open surgery was performed for complete removal of the lesions, and results of a routine pathological analysis revealed esophageal leiomyoma combined with adrenal cortical adenoma. The present study indicates that to avoid unnecessary surgeries, esophageal leiomyoma and adrenal cortical adenoma should be diagnosed through a comprehensive assessment with endoscopy, endoscopic ultrasound, computed tomography, magnetic resonance imaging and tissue sample pathology, not just PET.