Abstract
A 53-year-old man who underwent pylorus-preserving pancreatoduodenectomy (PPPD) under a diagnosis of duodenal leiomyosarcoma on December 7, 1993, was followed up and minor liver function impairment noted in October 2001. A cyst-shaped mass 7 cm in diameter of liver S4 was recognized in abdominal CT and the wall of the cyst was composed of tumor elements. Hepatic metastasis of duodenal leiomyosarcoma was strongly doubted and he underwent central bisegmentectomy of the liver on March 5, 2002. Histopathologically, findings were c-kit(+), CD34(-), SMA(-), desmin(-) and caldesmon(-), and the diagnosis was GIST. Because GIST may relapse 5 years or more after complete surgical resection such as in this case, long-term postoperative follow-up is a must.