A case of epithelioid leiomyosarcoma of the greater omentum is reported. A 69-year-old woman was referred to the hospital because of severe anemia. Abdominal CT scan revealed a tumor 11cm in diameter in the left upper abdomen. Angiography visualized that the tumor was mainly fed by the left gastroepiploic artery and an accumulation of contrast material was observed partially. A primary tumor of the greater omentum was suspected. Upon laparotomy. massive retention of blood in the abdominal cavity was confirmed and an easily bleeding and relatively soft tumor was present in the greater omentum. An enucleation of the tumor was performed. The enulceated material revealed a 13×9×4cm multilocular tumor covered with thin capsule, weighing 250g. Histopathologically it was composed of oval or spindle-shaped tumor cells with vacuolar cytoplasm, and so epithelioid leiomyosarcoma of the greater omentum was definitely diagnosed. In a review of the literature, epithelioid leiomyosarcoma of the greater omentum has been rarely reported. Especially the disorder presented with severe anemia due to massive intraabdominal bleeding is so rare that only two cases have been seen so far.
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