Abstract

Leiomyoma at gastroesophageal junction causing uncontrolled hypertension and arrhythmia

Author(s): Sagar Pamu*, Ramesh Sarangi, Mohammed Abubakar

A case of leiomyoma at gastroesophageal (GE) junction was identified in a male patient with uncontrolled hypertension and arrhythmia. Patient came with chief protestations of body pains, burping, stomach pain and uncontrolled hypertension. He was with oral medications like amlodipine 5 mg, pantoprazole 40mg, clopidogrel 75 mg, vitamin supplements and syrup antacid. His blood pressure was 150/100 mmHg. He has elevations of direct bilirubin-0.03mg/ dl and basic phosphate-192U/L. Esophagus endoscopy determines 23 × 22 mm size mixed echoic lesion with deformed cells at GE junction. His ECG demonstrates cardiac arrhythmias. Endoscopic ultrasonography and cardiac MRI identifies a mass from the submucosal layer at GE junction compressing the esophageal veins. Fibroids at GE junction were removed by thoracoscopy. Histopathological examination confirms leiomyoma with an impression of round mass lesion composed of bundle of spindle cells arranged like braid with minimal abnormal and enlarged nuclei. To his previous prescription ceftriaxone 500 mg and ibuprofen 400 mg were included