LEIOMYOSARCOMA ARISING FROM THE RESIDUAL STOMACH, REPORT OF A CASE AND REVIEW OF JAPANESE LITERATURE

Leiomyosarcoma of the residual stomach is extremely rare. Including the present case, there have been only six cases reported in Japan. A 71-year-old female who had undergone gastrectomy and gastroduodenostomy (Billroth I) because of gastric ulcer was admitted mainly with complaint of epigastralgia 11 years after the first surgery. By upper gastrointestinal series, gastrofiberscopic examination and CT-scan, she was diagnosed to have submucosal tumor of the residual stomach. Angiography of the celiac axis demonstrated a tumor stain with hypervascularity, which was supplied by the left gastric artery and the short gastric artery. Total resection of the residual stomach with dissection of the lymph nodes and reconstruction by Roux-Y method were performed. The resected tumor measuring 16×11×8cm in size showed exogastric growth, and no ulcer was observed on the mucasal surface of the tumor. Histology of the specimen revealed leiomyosarcoma. She showed metastasis in the liver 11 months after the second surgery. The clinical and pathological characteristics of leiomyosarcoma of the residual stomach are similar to that of leiomyosarcoma of the no-treated stomach.