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Patient: Male, 24-year-old Final Diagnosis: Giant esophageal leiomyoma Symptoms: Shortness of breath • productive cough • dysphagia Medication: — Clinical Procedure: — Specialty: Surgery Objective: Challenging differential diagnosis Background: Leiomyoma is a rare, benign, esophageal tumor that does not often measure >10 cm. Here, we report a case of giant esophageal leiomyoma in a 24-year-old man. Case Report: A 24-year-old man who smoked and had primary hypertension and glucose-6-phosphate dehydrogenase deficiency presented with a history of shortness of breath and productive cough with yellowish sputum, a long history of dysphagia to solid food, and a weight loss of 7 kg over 2 months. A chest X-ray revealed a mediastinum with a width >8 cm. Computed tomography of the patient’s chest revealed a multilobulated mass that originated from the upper and middle thoracic esophagus, caused severe narrowing of his esophageal lumen, and was compressing his trachea and right main bronchus. Resection of the tumor was performed and, because of the large defect after the surgery and the mucosal necrosis, the patient underwent an Ivor-Lewis esophagectomy. His postoperative course was uneventful. He had no symptoms when he was seen in the outpatient clinic for follow-up and fully recovered. Conclusions: Giant esophageal leiomyoma (GEL) is a rare oncological entity that presents several diagnostic and therapeutic challenges because of the scarcity of information in the medical literature on surgical management. The descriptions of techniques for surgical resection of GEL do not include ways to effectively perform subsequent reconstruction. The aim of the present paper was to contribute to this scant information by reporting our experience with performing an Ivor-Lewis esophagectomy to manage a case of GEL.

The outcomes of patient care are improved by adequate knowledge, practical skills, and positive attitude. Currently, there is a lack of data on medical research activities among resident doctors in Saudi Arabia. This study aimed to evaluate the perception, barriers, and research attitudes among various residency programs running in different cities of Saudi Arabia. A total of 434 surgical and medical residents participated in the current study. A cross-sectional study encompassing multiple training centers in the eastern province of Saudi. Convenient sampling technique was used to include all the working training residents. A self-administered questionnaire was formulated for data collection. Descriptive statistics were employed to analyze the data. The mean age of the residents with various specialties was 27.83 ± 2.41 years. Approximately 61.7% had participated in research, while 38.3% had never participated in any research. A total of 26% of junior and 44% of senior residents have one publication only. While 11% of junior and 9% of senior residents have three publications or more. Inadequate facilities for research, lack of baseline research skills, and personal commitments were the reasons which over 60% of respondents had agreed on. Institutional reasons: lack of professional supervisor support and lack of research curriculum in the training program was reported by 308 (71%) and 305(70.3%) residents, respectively. A lack of interest for research was prevailed more in males (19%) compared to females (14%) (OR 1.43, 95% CI: 0.86–2.38, p-value 0.17). A subset of residents had one or three publications, while some had none. A lack of baseline research skills and inadequate facilities for scientific explorations, time, and funds were the main constraints among training residents. However, several residents had a positive attitude toward research but fewer publications. Thus, training in medical research methodology should be obligatory in the residency curriculum in all specialties. Further research is needed.