腹腔鏡下に摘出した胃壁外型有茎性胃平滑筋肉腫の1例

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  • A Case of Pedunclated Gastric Leiomyosarcoma Resected under Laparoscopic surgery.

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A 67-years-old man with chronic hepatitis C admitted to our hospital for the investiga-tion of abdominal tumor which had been detected incidentally by ultrasonography and CT scanning. The tumor was 25 x 20mm in diameter and located between stomach and left lobe of the liver. Endoscopic ultrasonography showed solid low-echoic mass with small aechoic area, connecting to the proper muscle layer and located extragastrically at the lesser curvature of the gastric body. Laparoscopic examination revealed round pedunclat-ed mass, yellowish-white in color, developing on the gastric serosa. Abdominal angiogra-phy showed fine tumor vessels and tumor stain. Based on these findings, we diagnosed this as a pedunclated gastric tumor, possibly myogenic in origin. Because the tumor showed no remarkable findings of malignancy including its small size, we performed tumor resection under laparoscopy. Histologic findings showed leiomyosarcoma of low grade malignancy. Although laparoscopic surgery is performed commonly, this is the first case report about laparoscopic resection of extragastric tumor. As the tumor was small and had few tumor vessels, the therapeutic procedure using new kind of instrument was considerably easy without any complications. We conclude that laparoscopic surgery should be perform-ed for resection of such extragastric tumors.

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