Abstract
A 73-year-old man was admitted because of macrocytic anemia. He had had total gastrectomy R1 for leiomyosarcoma of the proximal stomach, 3 years earlier. An enhanced mass, 7 cm in diameter at the pancreatosplenic region, revealed by abdominal computed tomography, suggested recurrence of gastric leiomyosarcoma. Resection of the recurrent tumor with the spleen, pancreatic tail, diaphragm, transverse colon, lateral segment of the liver, interposed jejunum and lower esophagus was performed through an 8th intercostal thoracoabdominal incision. Another recurrent nodule, 1.5 cm in diameter in the muscle layer was found at esophagojejunostomy. As the origin of the former recurrence, residual tumor at the surgical margin was suspected. As for the latter, there is a possibility that implantation of the tumor occurred during the first operation.
