LEIOMYOSARCOMA OF THE REMNANT STOMACH ELEVEN YEARS AFTER UNDERGOING A DISTAL GASTRECTOMY FOR GASTRIC CARCINOMA-A CASE REPORT-

Abstract

Cases of leiomyosarcoma of the remnant stomach are very rare, and only thirty-two have been reported in Japan.
A 62-year-old woman who had undergone a distal gastrectomy (Billroth I) for gastric carcinoma 11 years previously was admitted with anorexia. Submucosal tumor of the remnant stomach was diagnosed by gastrointestinal series. An abdominal CT-scan showed a huge irregularly enhanced tumor, and a low density area in the liver was suspected metastasis. Angiography of the celiac axis demonstrated a tumor staining with hypervascularity, supplied by the short gastric artery and the left hepatic artery. A resection of the total remnant stomach was performed with lymph node dissection, splenectomy, distal pancreatectomy (body-tail), cholecystectomy, resection of the lateral segment of the liver, enucleation of the tumor located anterior segment of the liver and anastomosis of Roux-en Y method. The resected tumor measuring 20×15×12cm in size showed growth extragastric. Histological findings revealed leiomyosarcoma of the remnant stomach with liver metastasis.