Abstract
Multifocal leiomyosarcoma of the stomach is very rare. In Japan, only one case was reported. A multifocal gastric leiomyosarcoma with liver and lymph node metastases in a 47-year-old woman is discribed. Because of associated idiopathic portal hypertension, total gastrectomy with pancreatosplenectomy was performed in a two-step approach. The resected specimen showed two tumors in an upper portion of the stomach and a tumor in the body. Histologic examination revealed similar findings in all the tumors, which were composed of a differentiated portion with abundant smooth muscle fibers and a portion with epithelioid pattern. Three positive lymph nodes and two metastatic lesions of the liver were found histologically. After resection, chemotherapy with cisplatin, etoposide and mitomycin C through an intra-hepatic arterial catheter was performed. The patient have no recurrence over 1 year after operation.
