Clinicopathological Study of Smooth Muscle Neoplasms of Intestine

Toshikazu Kimura, Hideyuki Kimura, Motoo Kitamura, Syuuehi Hirose, Nobumasa Tsutsui, Toshinori Ohara, Tetsushige Mimura, Koutarou Toda, Kazuo Kataoka

Department of Surgery, Okayama Saiseikai General Hospital

The smooth muscle neoplasms of the intestine (10 cases of leiomyoma, 11 cases of leiomyosarcoma) that we have experienced in the past 20 years were studied clinicopathologically. Gl tract bleeding of unknown origin is the most common primary symptom, and may suggest a smooth muscle neoplasm. Leiomyosarcomas were complicated by peritoneal dissemination in 4 cases, liver metastasis in 3, lung metastasis in 1 and lymph node metastasis in 1, but lymph node metastasis appeared only in the highly advanced stage. The tumors were smaller than 5 cm in 8 cases of leiomyoma and 2 of leiomyosarcoma. On the other hand, in 2 cases of leiomyoma and 9 of leiomyosarcoma, the tumors were 5 cm or more, and also the death rate was higher. Therefore, neoplasms increase in malignancy in proportion to their size. All patients whose mitotic index was less than 3 are alive, while, all those whose mitotic index was 3 or more dead. Therefore, neoplasms also increase in malignancy in proportion to the mitotic index. Tumors smaller than 5 cm should be resected locally, and surgery, which is considered for quality of life even if radicality is not reduced, is preferable for tumors 5 cm or more.

Key words
relationship between tumor size and malignancy of smooth muscle neoplasms of intestine, metastasis and recurrence of leiomyosarcoma of intestine, relationship between mitotic index, tumor size and prognosis of leiomyosarcoma of intestine, margin of resection and lymph node resection of smooth muscle neoplasms of intestine

Reprint requests
Toshikazu Kimura Department of Surgery, Okayama Saiseikai General Hospital
1-17-18 Ihuku-cho, Okayama, 700, JAPAN

Accepted
December 12, 1990

To read the PDF file you will need Abobe Reader installed on your computer.