• 1. Kyles AE. Esophagus. In: Slatter D, ed. Textbook of small animal surgery. 3rd ed. Philadelphia: Saunders, 2002;573592.

  • 2. Kook PHL, Wiederkehr D, Makara M, et al. Megaesophagus secondary to an esophageal leiomyoma and concurrent esophagitis. Schweiz Arch Tierheilkd 2009;151:497501.

    • Search Google Scholar
    • Export Citation
  • 3. Kempf J, Beckmann K, Kook PH. Achalasia-like disease with esophageal pressurization in a myasthenic dog. J Vet Intern Med 2014;28:661665.

  • 4. Boria PA, Webster CRL, Berg J. Esophageal achalasia and secondary megaesophagus in a dog. Can Vet J 2003;44:232234.

  • 5. Matros L, Jergens AE, Miles KG, et al. Megaoesophagus and hypomotility associated with oesophageal leiomyoma in a dog. J Am Anim Hosp Assoc 1994;30:1519.

    • Search Google Scholar
    • Export Citation
  • 6. Changchien CS, Hsu CC. Use of sonography in the evaluation of the gastroesophageal junction. J Clin Ultrasound 1996;24:6772.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Halkiewicz F, Kasner J, Karczewska K, et al. Ultrasound picture of gastroesophageal junction in children with reflux disease. Med Sci Monit 2000;6:9699.

    • Search Google Scholar
    • Export Citation
  • 8. Gory G, Rault DN, Gatel L, et al. Ultrasonographic characteristics of the abdominal esophagus and cardia in dogs. Vet Radiol Ultrasound 2014;55:552560.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Willard MD. Alimentary neoplasia in geriatric dogs and cats. Vet Clin North Am Small Anim Pract 2012;42:693706.

  • 10. Lee LS, Singhal S, Brinster CJ, et al. Current management of esophageal leiomyoma. J Am Coll Surg 2004;198:136146.

  • 11. Farese JP, Bacon NJ, Ehrhart NP, et al. Oesophageal leiomyosarcoma in dogs: surgical management and clinical outcome of four cases. Vet Comp Oncol 2008;6:3138.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Arnell K, Hill S, Hart J. Persistent regurgitation in four dogs with caudal esophageal neoplasia. J Am Anim Hosp Assoc 2013;49:5863.

  • 13. Lister SA, Isakow K. A challenging case: esophageal leiomyoma in a dog. DVM360 2008; Nov 1. Available at: veterinarymedicine.dvm360.com/challenging-case-esophageal-leiomyoma-dog. Accessed May 16, 2015.

    • Search Google Scholar
    • Export Citation
  • 14. Rolfe DS, Twedt DC, Seim HB. Chronic regurgitation or vomiting caused by oesophageal leiomyoma in three dogs. J Am Anim Hosp Assoc 1994;30:425430.

    • Search Google Scholar
    • Export Citation
  • 15. Siersema PD. Stenting for benign esophageal strictures. Endoscopy 2009;41:363373.

  • 16. Homs MY, Steyerberg EW, Kuipers EJ, et al. Causes and treatment of recurrent dysphagia after self-expanding metal stent placement for palliation of esophageal carcinoma. Endoscopy 2004;36:880886.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17. Kim JH, Song HY, Shin JH, et al. Palliative treatment of unresectable esophagogastric junction tumors: balloon dilatation combined with chemotherapy and/or radiation therapy and metallic stent placement. J Vasc Interv Radiol 2008;19:912917.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18. Hansen KS, Weisse C, Berent AC, et al. Use of a self-expanding metallic stent to palliate esophageal neoplastic obstruction in a dog. J Am Vet Med Assoc 2012;240:12021207.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Lam N, Weisse C, Berent A, et al. Esophageal stenting for treatment of refractory benign esophageal strictures in dogs. J Vet Intern Med 2013;27:10641070.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Battersby I, Doyle R. Use of a biodegradable self-expanding stent in the management of a benign oesophageal stricture in a cat. J Small Anim Pract 2010;51:4952.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Glanemann B, Lildebrandt N, Schneider MA, et al. Recurrent single oesophageal stricture treated with a self-expanding stent in a cat. J Feline Med Surg 2008;10:505509.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22. Zhu YQ, Cheng YS, Li MH, et al. Temporary self-expanding cardia stents for the treatment of achalasia: an experimental study in dogs. Neurogastroenterol Motil 2010;22:12401247.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Cowling MG, Adam A. Gastrointestinal stenting: indications and techniques. In: Brandon JC, Teplick SK, eds. Nonsurgical therapies for the gut and abdominal cavity. New York: Thieme, 2001;3545.

    • Search Google Scholar
    • Export Citation
  • 24. Winkelbauer FW, Schofl R, Niederle B, et al. Palliative treatment of obstructing esophageal cancer with nitinol stents: value, safety, and long term results. AJR Am J Roentgeol 1996;166:7984.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Dua KS. Expandable stents for benign esophageal disease. Gastrointest Endosc Clin N Am 2011;21:359376.

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Esophageal leiomyoma in a dog causing esophageal distension and treated by transcardial placement of a self-expanding, covered, nitinol esophageal stent

Elisabeth M. RobinDepartment of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Université de Paris-Est, 94700 Maisons-Alfort, France.

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Pascaline B. PeyDepartment of Medical Imaging, Ecole Nationale Vétérinaire d'Alfort, Université de Paris-Est, 94700 Maisons-Alfort, France.

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Pauline de Fornel-ThibaudMICENVET, 58 rue Auguste Perret, 94000 Creteil, France.

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Pierre H. M. MoissonnierDepartment of Surgery, Ecole Nationale Vétérinaire d'Alfort, Université de Paris-Est, 94700 Maisons-Alfort, France.

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Valérie FreicheDepartment of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Université de Paris-Est, 94700 Maisons-Alfort, France.

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Abstract

CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement.

CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing. Transhepatic ultrasonographic and CT examination revealed a circumferential, intraparietal lesion in the distal portion of the esophagus causing distal esophageal or cardial subobstruction and no metastases. Incisional biopsy of the lesion was performed, and findings of histologic examination supported a diagnosis of esophageal leiomyoma.

TREATMENT AND OUTCOME In view of numerous possible complications associated with esophageal surgery, the decision was made to palliatively treat the dog by transcardial placement of a self-expanding, covered, nitinol esophageal stent under endoscopic guidance. Two weeks after stent placement, radiography revealed complete migration of the stent into the gastric lumen. Gastrotomy was performed, and the stent was replaced and fixed in place. Twenty-four months after initial stent placement, the dog had a healthy body condition and remained free of previous clinical signs.

CLINICAL RELEVANCE Diffuse benign muscular neoplasia should be considered as a differential diagnosis for acquired esophageal dilatation in adult and elderly dogs. In the dog of this report, transcardial stent placement resulted in resolution of the clinical signs, with no apparent adverse effect on digestive function. The described procedure could be beneficial for nonsurgical treatment of benign esophageal tumors in dogs.

Abstract

CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement.

CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing. Transhepatic ultrasonographic and CT examination revealed a circumferential, intraparietal lesion in the distal portion of the esophagus causing distal esophageal or cardial subobstruction and no metastases. Incisional biopsy of the lesion was performed, and findings of histologic examination supported a diagnosis of esophageal leiomyoma.

TREATMENT AND OUTCOME In view of numerous possible complications associated with esophageal surgery, the decision was made to palliatively treat the dog by transcardial placement of a self-expanding, covered, nitinol esophageal stent under endoscopic guidance. Two weeks after stent placement, radiography revealed complete migration of the stent into the gastric lumen. Gastrotomy was performed, and the stent was replaced and fixed in place. Twenty-four months after initial stent placement, the dog had a healthy body condition and remained free of previous clinical signs.

CLINICAL RELEVANCE Diffuse benign muscular neoplasia should be considered as a differential diagnosis for acquired esophageal dilatation in adult and elderly dogs. In the dog of this report, transcardial stent placement resulted in resolution of the clinical signs, with no apparent adverse effect on digestive function. The described procedure could be beneficial for nonsurgical treatment of benign esophageal tumors in dogs.

Contributor Notes

Dr. Robin's present address is CHV Fregis, 43 avenue Briand, 94110 Arcueil, France.

Dr. Pey's present address is Antech Imaging Services, 17672-B Cowan Ave, Irvine, CA 92614.

Address correspondence to Dr. Robin (erobinfregis@gmail.com).