A CASE OF EXTRAGASTORIC LEIOMYOSARCOMA WITH PEDUNCLE

In a 56-year-old man under the treatment of gastric ulcer with anemia, a submucosal tumor in the posterior wall of the middle portion of gastric corpus was accidentally found by upper gastrointestinal series and gastroendoscopy. Abdominal CT and unltrasonography revealed a solid mass about 7 cm in diameter, locating in front of the pancreas and presenting as extragastrical growth. An extragastrically growing leiomyosarcoma was strongly suspected preoperatively. On laparotomy, an egg-size tumor was found to be arising from the posterior wall of the corpus of the stomach. The mass was pedunculated and encapsulated with no evidence of invasion into the surrounding organs. No hepatic metastasis nor peritoneal dissemination was found. Subtotal gastrectomy with dissection of regional lymphnodes (R1) was performed. The resected mass measured 7.5×6.2×4.2 cm in size and lobulated with partial cystic degeneration.Pedunculated gastric leiomyomas growing extragastrically behave specifically and differently from those presenting as other growth patterns. Here we describe a case and discuss its clinicopathological features and some problems in the surgical treatment.