If a barium swallow shows a condition that is not achalasia, what is a likely diagnosis?

In the context of a barium swallow, which is a radiologic study used to visualize the esophagus, findings that are not indicative of achalasia can suggest several other conditions. A likely diagnosis in this scenario could indeed be esophageal leiomyoma.

Esophageal leiomyoma is a benign tumor of smooth muscle origin in the esophagus. When viewed on imaging studies like a barium swallow, it may appear as a submucosal mass that can cause an obstruction. Unlike achalasia, which typically presents with a dilated esophagus and failure to relax at the lower esophageal sphincter, an esophageal leiomyoma may create localized narrowing or a mass effect without the characteristic features of achalasia.

This combination of findings helps to distinguish it from other conditions. Esophageal cancer, for example, can also show evidence of obstruction or masses but usually presents with more severe symptoms and may feature additional characteristics on imaging, such as irregular borders or invasion of surrounding tissues, which would not be as typical for a benign leiomyoma. Gastroesophageal reflux disease (GERD) typically shows reflux patterns rather than a structural obstruction, while peptic ulcer disease is generally related to the stomach or duodenum and would not manifest