Gastric True Leiomyoma: Computed Tomographic Findings and Pathological Correlation

Objective: This study describes the computed tomographic (CT) findings of true leiomyomas in the stomach. Methods: Eleven patients with histopathologically proven gastric true leiomyomas were finally enrolled. All cases were CD117 (c-kit) negative on immunohistochemical study. We retrospectively reviewed the CT findings of gastric true leiomyomas for the following considerations: location, morphological features (size, contour, tumor growth pattern, and enhancement pattern), and ancillary findings (ulceration and calcification). Results: All leiomyomas were in the cardia, with an average tumor size of 36 mm (range, 13-47 mm). Computed tomography scans revealed the morphological features as follows: tumor growth pattern: intraluminal mass (n = 10) and extraluminal masses (n = 1); contour: lobulated margin (n = 7) or smooth margin (n = 4). All lesions showed homogeneous contrast enhancement. Most of the tumors showed lower enhancement than those in the liver (n = 10). One case showed ulceration but no calcification. Conclusions: In conclusion, gastric leiomyomas are mainly located in the cardia and usually appeared as homogenous low attenuated masses on computed tomography.

[1]  Cynthia Ludwig,et al.  Gastrointestinal tract , 2005, The American Journal of Digestive Diseases.

[2]  Jae Young Lee,et al.  Gastrointestinal stromal tumors of the stomach: CT findings and prediction of malignancy. , 2004, AJR. American journal of roentgenology.

[3]  Chi-Ming Lee,et al.  Gastrointestinal stromal tumor: Computed tomographic features. , 2004, World journal of gastroenterology.

[4]  L. Sobin,et al.  Gastrointestinal stromal tumors: radiologic features with pathologic correlation. , 2003, Radiographics : a review publication of the Radiological Society of North America, Inc.

[5]  C. Fisher,et al.  Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. , 2003, Radiology.

[6]  G. Ahn,et al.  Schwannomas of the gastrointestinal tract: clinicopathological features of 12 cases including a case of esophageal tumor compared with those of gastrointestinal stromal tumors and leiomyomas of the gastrointestinal tract. , 2002, Pathology, research and practice.

[7]  Y. Shim,et al.  Esophageal Leiomyoma: Radiologic Findings in 12 Patients , 2001, Korean journal of radiology.

[8]  J. Lasota,et al.  Gastrointestinal stromal tumors – definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis , 2000, Virchows Archiv.

[9]  L. Sobin,et al.  Esophageal stromal tumors: a clinicopathologic, immunohistochemical, and molecular genetic study of 17 cases and comparison with esophageal leiomyomas and leiomyosarcomas. , 2000, The American journal of surgical pathology.

[10]  L. Sobin,et al.  Prognosis of gastrointestinal smooth-muscle (stromal) tumors: dependence on anatomic site. , 1999, The American journal of surgical pathology.

[11]  L. Kindblom,et al.  Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. , 1998, The American journal of pathology.

[12]  K. Kawamoto,et al.  Endoscopic submucosal tumorectomy for gastrointestinal submucosal tumors restricted to the submucosa: a new form of endoscopic minimal surgery. , 1997, Gastrointestinal endoscopy.

[13]  G. Gabella,et al.  Origin of the c-kit-positive interstitial cells in the avian bowel. , 1996, Development.

[14]  M. Miettinen,et al.  Gastrointestinal stromal tumors--value of CD34 antigen in their identification and separation from true leiomyomas and schwannomas. , 1995, The American journal of surgical pathology.

[15]  T. Kakegawa,et al.  Two laparoscopic techniques for resection of leiomyoma in the stomach. , 1995, Surgical laparoscopy & endoscopy.

[16]  H. Evans Smooth muscle tumors of the gastrointestinal tract. A study of 56 cases followed for a minimum of 10 years , 1985, Cancer.

[17]  G. Farr,et al.  Myosarcomas of the stomach: Natural history, prognostic factors and management , 1982, Cancer.

[18]  O. Beahrs,et al.  Leiomyosarcoma of the small and large bowel , 1978, Cancer.

[19]  R. Kempson,et al.  Smooth muscle tumors of the gastrointestinal tract and retroperitoneum. A pathologic analysis of 100 cases , 1977, Cancer.