Leiomyosarcoma of the stomach: A case report

Abstract

BACKGROUNDLeiomyosarcoma of the stomach is extremely rare, and only 13 cases have been reported in the literature. Before the advent of KIT immunohistochemistry, gastrointestinal stromal tumors (GISTs) were misdiagnosed as leiomyomas and leiomyosarcomas. Leiomyosarcoma rarely occurs in organs besides the uterus and is rarely located in the stomach.CASE SUMMARYA 57-year-old woman presented with the symptom of melena over a one-month period. She had suffered weight loss, weakness, nausea and vomiting for fifteen days. At a local hospital, computed tomography showed a very large mass in the stomach, and the results of endoscopic examination and histopathological diagnosis were unclear. She received transfusion therapy and was transferred to our hospital. Upon arrival at our hospital, the patient was anemic. She denied any family history and had no specific past history. No signs of pulmonary metastasis were found on chest radiographs. Magnetic resonance imaging and computed tomography confirmed a very large tumor in the stomach, and no visible signs of metastatic disease were found. On October 30, 2013, the patient underwent resection of the stomach tumor and did not undergo any adjuvant treatment. The margins were negative and she had an uneventful recovery and was discharged after 12 d. One year after surgery, the patient died at home, and the cause of death were gastrointestinal obstruction and malnutrition. During that time, she was treated with Chinese medicine but the effect was not ideal. Because of gastrointestinal obstruction, the patient did not receive any re-examination.CONCLUSIONSurgical resection is the standard treatment for gastric leiomyosarcoma. The diagnosis of this tumor mainly depends on histopathological examination. This case may suggest the aggressive behavior and poor prognosis of this tumor.

Laparoscopic and endoscopic cooperative surgery for leiomyosarcoma of the stomach: a case report with a review of the literature

“…Most cases reported in the “pre-KIT era” as leiomyosarcoma of the stomach might be GISTs [ 2 ]. Only 19 cases of leiomyosarcoma of the stomach have been reported since early 2000s (Table 1 ), including our patient in this report.…”

“…Diagnosis of leiomyosarcomas relies on histopathological examination of biopsies from deeper layer because these arise between the muscularis propria and muscularis mucosa layers [ 2 ]. Conventional endoscopy usually yields superficial and normal mucosa [ 12 ].…”

“…Pauser et al also reported endoscopic resection of leiomyosarcoma of the stomach that was unexpectedly diagnosed because they initially suspected the lesion to be a hyperplastic polyp or an adenoma [ 11 ]. However, ESD for mesenchymal tumors in gastrointestinal tracts might lead to incomplete resection since they could originate from deeper layer of the intestinal wall [ 2 ].…”

“…Leiomyosarcoma is a rare tumor that could originate from the gastrointestinal tract, uterus, kidney, retroperitoneum, and the soft tissues of the extremities [ 1 ]. Primary leiomyosarcoma of the stomach is extremely rare, and most cases reported as leiomyosarcoma of the stomach before the development of KIT immunohistochemistry (pre-KIT era) might be gastrointestinal stromal tumors (GISTs) of the stomach [ 2 ]. To the best of our knowledge, only 18 patients with leiomyosarcoma of the stomach have been described in the literature.…”

“…To the best of our knowledge, only 18 patients with leiomyosarcoma of the stomach have been described in the literature. Currently, the standard treatment is surgical resection of the tumor [ 2 ]. Herein, we report a patient with extremely rare leiomyosarcoma of the stomach.…”