Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Jul:108:108433.
doi: 10.1016/j.ijscr.2023.108433. Epub 2023 Jun 21.

A case report of esophageal leiomyoma in Alport's syndrome treated with robotic-assisted distal myotomy: A surgical technique to avoid esophagectomy

Affiliations
Case Reports

A case report of esophageal leiomyoma in Alport's syndrome treated with robotic-assisted distal myotomy: A surgical technique to avoid esophagectomy

Flavio Roberto Takeda et al. Int J Surg Case Rep. 2023 Jul.

Abstract

Introduction: Alport's syndrome is the most common hereditary nephropathy, characterized by progressive renal failure, sensorineural deafness, and ocular abnormalities. It may rarely coexist with diffuse leiomyomatosis of the digestive tract, respiratory tract, or female genitalia, and in this setting, it is called Alport-leiomyomatosis syndrome. The leiomyomas most commonly affect the esophagus, and the symptoms have early onset. Treatment is usually esophagectomy.

Case presentation: We report the case of an 8 years-old girl in which we performed a novel strategy of an esophagus-sparing approach with a robotic-assisted myotomy. This conservative approach has never been described in the literature to our knowledge.

Discussion: The underpinning rationale was to resolve the patient's symptoms with partial resection of the benign tumor, avoiding an esophagectomy. Although it is likely related to a higher relapsing rate, it is more tolerable by an 8 years-old patient, and was highly effective in resolving her symptoms.

Conclusion: The video of a successful minimally invasive conservative approach to esophageal leiomyomatosis is presented.

Keywords: Case report; Dysphagia; Esophagectomy; Leiomyomatosis; Robotic surgical procedures.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest Authors declare that there is no actual or potential conflict of interest in relation to this article.

Figures

Fig. 1
Fig. 1
Comparison between preoperative (left) and postoperative (right) esophagogram, showing a significantly better esophageal clearance and adequacy of the esophageal axis and esophagogastric junction (EGJ) positioning.

Similar articles

References

    1. Nozu K., Minamikawa S., Yamada S., et al. Characterization of contiguous gene deletions in COL4A6 and COL4A5 in Alport syndrome-diffuse leiomyomatosis. J. Hum. Genet. 2017;62:733–735. doi: 10.1038/jhg.2017.28. - DOI - PubMed
    1. Hasstedt S.J., Atkin C.L. X-linked inheritance of Alport syndrome: family P revisited. Am. J. Hum. Genet. 1983;35:1241–1251. - PMC - PubMed
    1. Pajari H., Kääriäinen H., Muhonen T., Koskimies O. Alport’s syndrome in 78 patients: epidemiological and clinical study. Acta Paediatr. 1996;85:1300–1306. - PubMed
    1. Dahan K., Heidet L., Zhou J., Mettler G., Leppig K.A., Proesmans W., David A., Roussel B., Mongeau J.G., Gould J.M., et al. Smooth muscle tumors associated with X-linked Alport syndrome: carrier detection in females. Kidney Int. 1995;48(6):1900–1906. doi: 10.1038/ki.1995.489. 8587250 - DOI - PubMed
    1. Uliana V., Marcocci E., Mucciolo M., Meloni I., Izzi C., Manno C., Bruttini M., Mari F., Scolari F., Renieri A., Salviati L. Alport syndrome and leiomyomatosis: the first deletion extending beyond COL4A6 intron 2. Pediatr. Nephrol. 2011;26(5):717–724. doi: 10.1007/s00467-010-1693-9. 21380622 (Epub 2010 Dec 14) - DOI - PubMed

Publication types