A Resected Case of Gastric Leiomyosarcoma with Adrenal Metastasis after Effective CYVADIC Chemotherapy and Transcatheter Arterial Embolization

Kazunori Shimada¹⁾²⁾, Jun Maeda²⁾, Masaki Hirota¹⁾, Osamu Takahashi¹⁾ and Suguru Obunai¹⁾

¹⁾Department of Surgery, National Ehime Hospital
²⁾Department of Surgery, Osaka University Graduate School of Medicine

A 71-year-old man admitted for tarry stool on July 30, 1999, was found in upper gastrointestinal series and gastric endoscopy to have two protruding lesions in the stomach and biopsy of each showed leiomyosarcoma. Abdominal computed tomography (CT) showed a 30×25 mm mass in the right adrenal gland.
Ultrasonography-guided needle biopsy was done and right adrenal metastasis from gastric leiomyosarcoma diagnosed. We partially resected the stomach on September 13. Subsequent CYVADIC chemotherapy consisting of cyclophosphamide, vincristine, adriamycin, and dacarbazine dramatically reduced the metastatic adrenal lesion after one course. The lesion, estimatable in computed tomography, was reduced to 60% in size. After transcatheter arterial embolization on November 10, the lesion was reduced to 80% in size. No metastases were identified in other organs, enabling right adrenalectomy on March 1, 2000. No viable cell were found pathologically in the adrenal lesion. The man remains alive and recurrence-free 3 years and 3 months after the second surgery.
CYVADIC chemotherapy and transcatheter arterial embolization are thus effective in treating advanced gastric leiomyosrcoma.

Key words
gastric leiomyosarcoma with adrenal metastasis, CYVADIC, transcatheter arterial embolization

Reprint requests
Kazunori Shimada Department of Surgery, Osaka University Graduate School of Medicine
2-2 Yamadaoka, Suita, 565-0871 JAPAN

Accepted
July 23, 2003

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