A Case of Adenocarcinoma and Leiomyosarcoma coexisting Independently in the Same Stomach

Atsushi Sato, Kei Torii, Manabu Kobayashi, Takao Kasugai, Masahiro Kimura, Tetsuo Hotta

The Department of Surgery, National Ena Hospital

A case of adenocarcinom and leiomyosarcoma coexisting independently in the same stomach is reported. A 73-year-old man came to our hospital complaining of a floating feeling on walking. His hemoglobin level was 6.7 g/dl. X-ray and endoscopic examination of the stomach revealed a large submucosal tumor in the posterior wall of the fundus and a tumor like Borrmann 2 advanced cancer in the anterior wall of the corpus coexisting independently. Biopsy specimens from the tumor of the cardia revealed myogenic tumor, and those from the other tumor showed adenocarcinoma. Abdominal CT and ultrasonography revealed that the myogenic tumor grew inside and outside the stomach wall. Total gastrectomy with lymph node resection was performed. The resected tumor in the cardia was histopathologically diagnosed as leiomyosarcoma growing 10×6×5.5 cm inside and 11×9×7.5 cm outside the stomach wall. The cut surface showed necrosis and hemorrhage. The other tumor was diagnosed as moderately differentiated papillo-tubular adenocarcinoma invading within the submucosal layer, that is, early cancer. The Japanese literature contains reports of 28 cases of the independent coexsistence of carcinoma and leiomyosarcoma in the same stomach excluding carcinosarcoma. The literature is reviewed.

Key words
carcinoma and leiomyosarcoma of stomach

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

Accepted
June 17, 1992

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