1996 Volume 29 Issue 8 Pages 1772-1776
A 67-year-old female was admitted for investigation of liver dysfunction. Abdominal ultrasound examination and computed tomography revealed a solid tumor of approximately 4cm in diameter between the stomach and the liver. Selective celiac angiography revealed a hypervascular mass whose blood flow was supplied by the left gastric artery. An operation was performed in May 1994 under the diagnosis of an exogastric leiomyoma. At laparotomy a pedunculated exogastric tumor was found arising from the lesser curvature of the gastric upper body as a 0.5 cm pedunculus. A wedge resection was performed. Microscopically, hematoxylin-eosin stained sections showed that the tumor consisted of spindle cells arranged in a palisade and the tumor was diagnosed as a neurilemmoma because glial fibrillary acidic protein staining was positive in the tumor cells. According to the literature, only 3 cases of pedunculated exogastric neurilemmoma including ours have been reported in Japan (1974-1995). An exogastric pedunculated configuration is rare. No particular difference was found between these cases and non-pedunculated neurilemmoma. Histopathological diagnosis was reported to be rarely obtained prior to the resection. Wedge resection of the stomach turned out to be adequate therapy for our patient, although a standard treatment regimen for this rare disease has not been established to date.
