A CASE OF EXTRAMURALLY GROWING LEIOMYOSARCOMA OF THE STOMACH WITH INTRA-ABDOMINAL BLEEDING

Abstract

A 72-year-old man was admitted to the hospital because of upper abdominal pain and abdominal full sensation. Gastrointestinal fiber revealed a gastric ulcer in the upper portion in the gastric body adjacent to the greater curvature. Abdominal CT showed the fluid collection in the upper abdomen and the tomor with the size of 8cm between the left lobe of the liver and spleen. Emergency operation was carried out with the diagnosis of intra-abdominal bleeding and tumor. Approximately 1L of hemorrhagic ascitis was noted, as well as the extramurally growing tumor in the upper portion of the gastric body adjacent to the greater curvature A total gastrectomy with lymph nodes dissection (D1) and ρ-Roux en Y anastomosis was performed. The resected material revealed that the tumor formed small ulcer on the gastric mucosa at the upper portion of gastric body adjacent to the greater curvature, mainly grooved extramurally, and a portion of the tumor destructed with torn capsule. It is uncommon that the disease presented with abdominal bleeding from the tumor. Pathological diagnosis was leiomyosarcoma of the stomach. It is difficult to diagnose the extramurally growing leiomyosarcoma of the stomach preoperatively. Reviewing the past reports of the extramurally growing leiomyosarcoma of the stomach presented with intraabdominal bleeding, clinicopathological features were investigated.