A Case of Duodenal Leiomyoblastoma Presenting as Extraluminal Cystic Growth

Shigeharu Moriyama, Toshihito Hanaoka, Kunihiro Kawashima, Ryuichiro Ohashi, Takahiro Kinoshita, Tetsunobu Udaka

Department of Surgery, Fuchu General Hospital

We report a case of leiomyoblastoma of the duodenum which rarely originates in the extragastric alimentary tract. A 60-year-old woman suffering from hypoplastic anemia had noticed a right lower abdominal tumor in 1986, but she had not consulted a doctor because she had no abdominal symptoms. In February 1989 she was admitted to our hospital for an operation for a left external inguineal hernia and then complained of the abdominal tumor. Ultrasonography and computed tomography revealed a cystic mass in the right lower abdomen and surgery was performed for both the inguinal hernia and the abdominal tumor. On laparotomy, neither peritoneal dissemination, nor liver nor lymph node metastasis was observed. The tumor originated in the anterior wall of the second portion of the duodenum and was resected with the muscular layer of the duodenum. The tumor, 10.0×9.5×9.0 cm in size, 550 g in weight, was a thin-walled cystoma containing dark reddish serous fluid and a massive amount of white yellowish debris. No connection with the duodenal lumen was noticed. Histologic examination revealed hemorrhage and necrosis in the cyst wall and two cell components, spindle-shaped cells and large round or polygonal eosinophilic clear cells. The histopathologic diagnosis was leiomyoblastoma (epithelioid leiomyoma) without malignant findings. The patient has been well for about 3 years and 5 months after surgery, without any signs of recurrence.

Key words
leiomyoblastoma, duodenal leiomyoblastoma

Reprint requests
Shigeharu Moriyama Department of Surgery, Fuchu General Hospital
555-3, Ukai-cho, Fuchu City, 726 JAPAN

Accepted
November 11, 1992

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