Abstract
Leiomyosarcoma of the stomach is reported to account for about 1% of the gastric malignancies. Cases of intraabdominal bleeding or hemoperitoneum are rare. We report a surgical case with massive ascites of about 10l. The patient was a 71-year-old man with abdominal mass in the epigastric region who was diagnosed with leiomyosarcoma of the stomach. He refused surgery, but after 20 months, massive abdominal distension appeared, and he was admitted to our hospital for tests. He was suspected of having a submucosal tumor of the stomach with massive ascites. At surgery, a 10cm tumor growing extraluminally from the anterior wall of the antrum was observed. Subtotal gastrectomy with partial lateral segmentectomy of the liver was performed. The histological diagnosis was leiomyosarcoma of the stomach. We suspected that the massive bloody ascites was due to increased vascular permeability of the peritoneum caused by rupture of the necrotic tissue of the tumor with bleeding.
