Abstract
A 64-year-old male was admitted to the hospital. there was a history of undergoing distal gastrectomy for a gastric leiomyosarcoma one year before. After the operation he was followed by a near hospital, and recently, a ultrasonographic examination of the abdomen disclosed a cystic mass, 66 by 59 mm, in the posterior region of the liver. On admission to the hospital, CT scans of the liver showed a cystic lesion with a thicked well in the right posterior region. The wall of the mass enhanced in the contrast CT scan. A ultrasonic-guided needle biopsy of the mass revealed metastatic carcinoma of gastric leiomyosarcoma. Operation by right lobectomy and resection of caudal lobe were performed. Postoperative course was uneventful and the patient was discharged from the hospital on 24th day after operation.
Liver metastasis of the gastric leiomyosarcoma tends to present as melting necrotic change, cystic lesion and multiple progression. So these lesions are often inoperable. There are several reports that arterial embolization was useful for these tumors, where hypervascularity in the tumor wall was turned to account.
In conclusion, liver resection should be recommeneded for liver metastasis of the gastric leiomyosarcoma, because the tumor is a decisive factor of the prognosis.
