1. Leiomyosarcomas
1.1. super, super rare. Like case studies only kinda rare
1.2. Imaging
1.2.1. Fluoro
1.2.1.1. large intramural mass
1.2.1.1.1. may have exophytic component
1.2.1.1.2. mass effect on trachea
1.2.2. CT
1.2.2.1. large mass causing mass effect
1.2.3. MR
1.2.3.1. T1 iso to skeletal muscle
1.2.3.2. T2 hyper to skeletal muscle
2. Leiomyoma
2.1. what?
2.1.1. most common, benign mass
2.1.2. smooth muscle
2.1.3. mid to distal oesophagus
2.2. who?
2.2.1. young/middle aged
2.2.2. men > women
2.3. presentation
2.3.1. small tumours
2.3.1.1. asymptomatic
2.3.2. larger
2.3.2.1. dysphagia
2.3.2.2. regurg
2.3.2.3. obstruction/chest pain
2.4. imaging
2.4.1. barium
2.4.1.1. ovoid mass
2.4.1.2. obtuse angle
2.4.1.2.1. sign of benignity
2.4.2. CT
2.4.2.1. ovoid, smooth mass
2.4.2.2. causing
2.4.2.2.1. narrowing or displacement of oesophagus
2.4.2.3. calcifications are pathognomonic
2.4.2.4. moderate, diffuse enhancement
2.5. tx
2.5.1. chop it out if it's symptomatic
3. GIST
3.1. fairly uncommon, 1% of all GISTs
3.1.1. can be benign or malignant
3.1.1.1. chop it out
3.1.2. lymph node enlargement is not a feature
3.2. Imaging
3.2.1. exophytic mass
3.2.2. necrosis, calcifications and haemorrhage
3.2.3. MR
3.2.3.1. T1 hypo in the solid bit
3.2.3.2. T2 hyper in the solid bit
3.2.3.3. Contrast
3.2.3.3.1. midl, heterogenous enhancement
3.2.3.4. Restriction
3.2.3.4.1. yes. Lower ADC values related to higher risk
3.2.4. FDG
3.2.4.1. avid
3.2.4.1.1. usual for staging and tx response
3.2.4.2. necrosis will be photopenic
4. Fibrovascular Polyp
4.1. super rare
4.2. usually sits around cricoid
4.2.1. can regurgitate
4.2.1.1. asphyxia
4.2.1.1.1. death!
4.2.2. elongated, intraluminal mass
4.3. imaging
4.3.1. right sided mediastinal mass