A Case of Multiple Liver Metastasis of True Gastric Leiomyosarcoma after Complete Surgical Resection

ABSTRACT

Primary leiomyosarcomas of the stomach are very rare tumors originating from mesenchymal tissues and account for only 1% of all malignant gastric neoplasm. We present here a case of primary gastric leiomyosarcoma in a 79-year-old man who presented with a 10 day history of epigastric pain and gastric subepithelial tumor. Endoscopic examination showed a 5 cm in diameter, subepithelial tumor located in the body of the stomach. Radiological investigations showed nonspecific findings except for the primary gastric lesion. Complete histological evaluation including immnuohistochemical staining after complete surgical resection revealed a true leiomyosarcoma of the stomach. One year later, the patient presented with dyspepsia. Endoscopic and radiological evaluation showed a recurrent leiomyosarcoma with multiple liver metastases. Our experience suggests that a careful clinical follow-up after surgical resection should be recommended in patients with gastric leiomyosarcomas because of their aggressive clinical behavior.