Abstract
A 55-year-old man with chronic hepatitis was referred to our hospital for investigation of the gastric extramural tumor which had been incidentally detected in a local hospital during peritoneoscopical examination. Sonography showed small hypoechoic mass lesion containing a echogenic spot, at the anterior wall of the stomach. Biopsy specimen of this mass lesion obtained under second peritoneoscopical examination showed round and spindle cells with large nuclei and nucleoli. Other examinations, such as upper GI X-ray, abdominal CT scan or abdominal angiography showed no abnormality, and no malignant cells could be obtained by needle biopsy under gastrofiberscopy. Subtotal gastrectomy was performed in the clinical diagnosis of gastric myogenic or neurogenic malignancy. Surgical findings revealed extramural tumor at the gastric anterior wall, measuring 1.6×0.8×0.8 cm in diameter, and final diagnosis of leiomyoblastoma was histologically established. The size of this tumor was the smallest among gastric extramural leiomyoblastoma reported in Japan. Finally, we reviewed reported 209 cases of gastric leiomyoblastoma of Japan and stressed that, in the light of opportunity to detect by ultrasonography or peritoneoscopy such small gastrointestinal tumors, particular attention must be paid also to the gastrointestinal region during ultrasonographic or peritoneoscopic examination.
