A Case of Extragastric Leiomyoblastoma with Peduncle

Kazuyuki Matsushita, Akio Sakamoto, Sadahito Usui, Souketsu Shu, Satoshi Takaishi, Yoshihiro Nabeya, Masahiko Ozaki, Noriyuki Tounosu, Kazuaki Okuyama, Shouichi Onoda, Kaichi Isono

The Second Department of Surgery, Chiba University School of Medicine

A 65-year-old female with leiomyoblastoma of the stomach was admitted to our hospital. An operation was performed in September 1988 under the diagnosis of a submucosal tumor of the stomach. At laparotomy a pedunculated extragastric tumor was noted on the superior-anterior wall of the gastric body. A quickfrozen section revealed gastric leiomyoblastoma and a partial gastrectomy was peformed. There was no evidence of metastasis nor direct invasion to the neighboring organs. The surface of the excised tumor was uneven and the tumor measured 3.5×2.5 cm in diamiter. On cross section the tumor was shown to have cysts and solid portions which contained foci of hemorrhage and necrosis. Microscopically, hematoxylin-eosin-stained sections the tumor was found to be composed of rounded or polygonal cells with abundant eosinophilic cytoplasma and round an centrally located nuclei. Individual or a few tumor cells demonstrating an alveolar pattern in silver-stained sections suggested a non-epithelial origin. Electron microscopy reveals myofilaments and dense patches in a few tumor cells, indicating a smooth muscle origin. According to the review of 228 cases of gastric leiomyoblastoma which have been reported in Japan (1964-1987), no cases showed metastasis nor direct invasion to the neighboring organs if the tumor was smaller than 5 cm in diameter at the operation. The l0-year survival rate was 88.8% in 69 cases, Of those 69 cases, metastasis or direct invasion to the neighboring organs was found in 13 cases at the opeation. The 5-year and the l0-year suvival rate for the 13 cases were 71.3% and 45.5%, respectively.

Key words
submucosal tumor of the stomach, extragastric tumor with peduncle, leiomyoblastoma of the stomach

Reprint requests
Akio Sakamoto 2nd Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chiba, 280 JAPAN

Accepted
October 11, 1989

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