A Case of Leiomyoblastoma of the Stomach with Pedunculated Extramural Progression and Marked Cystic Change

Hiroyuki Kawamura, Makoto Kataoka, Yoshiyuki Kuwabara, Yasuyuki Kureyama, Hiroshi Iwata, Noriyuki Shinoda, Taketoshi Kashima, Atsushi Satou, Kouji Hattori, Kouichirou Nakano, Akira Masaoka

The Second Department of Surgery, Nagoya City University of Medical School

A case of leiomyoblastoma of the stomach that showed an unusual growth pattern is reported. The patient was a 69-year-old female who was admitted with a chief complaint of abdominal mass the size of a fist in the right epigastric region. Ultrasound examination indicated that the mass was cystic in the upper and lower poles and solid in the center. MRI defined a gastric submucosal tumor which had grown beyond the gastric wall. After endoscopic biopsy, bleeding was observed from the biopsy site, and emergency operation was performed. Laparotomy revealed a pedunculated tumor growing extramurally from the pyloric greater curvature. Wedge resection of the stomach, including the mass, was performed. A diagnosis of low grade malignant leiomyoblastoma was made histologically. About 10% of leiomyoblastoma is malignant, and extended gastrectomy is considered to be needed in case of multiple tumors or when the tumor has markedly invaded the gastric wall. However, when the tumor grows as a pedunculated extragastric lesion, no invasion into the gastric wall is observed, and no lymph node enlargement is noted as in our case, wedge resection is considered to be sufficently curative.

Key words
leiomyoblastoma of the stomach, pedunculated extramural progression, findings of magnetic resonance imaging

Reprint requests
Hiroyuki Kawamura Second Department of Surgery, Nagoya City University of Medical School
1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467 JAPAN

Accepted
January 13, 1993

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