Giant oesophageal leiomyoma causing severe hypertension

Leiomyoma is the most common oesophageal tumour and is symptomatic in about half of the patients. Dysphagia is the most common symptom. A 41-year-old woman presented with recent onset of severe orthostatic hypertension. During the cardiological work-up, a mediastinal mass was found at transthoracic echocardiogram. Further investigation (upper gastrointestinal endoscopy, endoscopic ultrasonography, CT scan and cardiac MRI) confirmed the diagnosis of a large oesophageal submucosal mass compressing the supradiaphragmatic inferior vena cava. The mass was resected through a minimally invasive right thoracoscopic approach with complete relief of symptoms and compression on the vena cava.