Rou Woo Sun, Ju Jong Seok, Kang Sun Hyung, Moon Hee Seok, Sung Jae Kyu, Lee Byung Seok, Jeong Hyun Yong, Song Kyu Sang
Departments of Internal Medicine and Pathology, Chungnam National University College of Medicine, Daejeon, Korea.
Korean J Gastroenterol. 2015 Feb;65(2):112-7. doi: 10.4166/kjg.2015.65.2.112.
Leiomyosarcoma is an uncommon tumor that originates from various organs, including uterus, kidney, retroperitoneum, and soft tissues. In particular, leiomyosarcoma of the stomach is extremely rare. Only 9 cases have been reported worldwide since the discovery of KIT-activating mutation. A 48-year-old woman was admitted to our hospital with abdominal discomfort and generalized weakness. Upon detection of multiple nodules in both lung on chest posterior-anterior radiograph taken at the time of admission, chest CT was performed and it revealed multiple mass lesions in the lung, liver, and pancreas along with multiple lymph node metastases. On endoscopic examination, a 2.0 cm sized ulcerofungating mass lesion was found on the stomach body. Biopsy was performed and the mass lesion proved to be leiomyosarcoma confirmed by immunohistochemical staining. Chemotherapy was thus initiated, but the patient died after one year due to tumor progression. Our experience suggests that leiomyosarcoma can manifest aggressive behavior in its early stage. Herein, we report a case of gastric leiomyosarcoma with multiple metastases along with review of relevant literature.
平滑肌肉瘤是一种罕见的肿瘤,起源于包括子宫、肾脏、腹膜后和软组织在内的各种器官。特别是胃平滑肌肉瘤极为罕见。自发现KIT激活突变以来,全球仅报道了9例。一名48岁女性因腹部不适和全身乏力入院。入院时胸部正位X线片发现双肺多发结节,遂行胸部CT检查,结果显示肺、肝、胰腺多发肿块病变及多发淋巴结转移。内镜检查发现胃体部有一个2.0 cm大小的溃疡型肿块病变。进行了活检,免疫组化染色证实肿块病变为平滑肌肉瘤。于是开始化疗,但患者在一年后因肿瘤进展死亡。我们的经验表明,平滑肌肉瘤在早期可能表现出侵袭性。在此,我们报告一例伴有多发转移的胃平滑肌肉瘤病例,并对相关文献进行综述。