A Case of Gastric Leiomyosarcoma, Showing Pedunculated Extragastric Development, Revealed by Ultrasonography

Masakazu Ueda, Hirohiko Kojima, Hiroshi Asano, Kimio Wada, Tomoyoshi Shinohara

Department of Surgery, Nagoya Tokushukai Hospital

Ultrasonography occasionally revealed a tumor in the abdomen of a 76-year-old woman hospitalized for lumbago. The ultrasonography differentiated it from tumors of other organs, but not its primary origin, the same as with CT scanning. Angiography revealed a tumor in the upper body of the stomach, while gastric transillumination and a gastrocamera revealed no lesion in the gastric mucosa, so that a gastro-myogenic tumor was suspected in terms of its incidence. Laparotomy revealed a pedunculated myogenic tumor developing extragastrically from the posterior wall of the upper body of the stomach. It mesured 38×28×55 nm, weighted 35 g and its cross section showed white solid tumor with several parts of necrosis. The tumor showed neither metastasis norperitoneal dissemination and the patient received a local resection and an exploratory lymphadenectomy. Postoperative histopathological examination led to the diagnosis of gastric leiomyosarcoma without metastasis in the resected lymph node. Gastric leiomyosarcoma showing pedunculated extragastric development is very rare and that no report has previously been made of the disease diagnosed asymptomatically. Ultrasonography, which is noninvasive and enables us to obtain much information with ease, is considered a test worth trying for early detection of the disease in aged persons, in whom there are no symptoms but there is high prevalenece.

Key words
gastric leiomyosarcoma, abdominal ultrasonography, celiac angiography

Reprint requests
Masakazu Ueda Department of Surgery, Nagoya Tokushukai Hospital
2-28 Kozoji-cho, Kasugai, 487 JAPAN

Accepted
April 11, 1990

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