腹腔内再発を4回切除し長期生存中の胃平滑筋肉腫の1例

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  • A CASE OF GASTRIC LEIOMYOSARCOMA UNDERGOING FOUR RESECTIONS FOR INTRAPERITONEAL RECURRENCE OVER 7 YEARS

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A 61-year-old woman was admitted to the hospital because of a tumor in the left upper abdomen. A gastrointestinal series revealed an extragastric type of leiomyosarcoma of the stomach with central necrosis. Partial gastrectomy without lymph node dissection was perfomed on June 16, 1986. The resected encapselated tumor with central necrosis, 26×23×6cm in size and 1, 570g in weight, was histologically diagnosed as leiomyosarcoma. During six years and six months after the initial operation, four operations were carried out for intraperitoneal recurrent tumors. First recurrent tumor was located in the perigastic area and the other three were in the mesoileum. a partial distal gastrectomy with splenectomy, pan-createctomy (body and tail), partial colectomy and partial resection of the ileum was perfomed for the first recurrent tumor, following by extirpations, sigmoidectomy and partial resction of the ileum for the latter recurrent tumors. All recurrent tumors were diagnosed as leiomyosarcoma. Up to now, the patient has been leading a good life without recurrence. A suspected cause of these recurrences was implantation of tumor cells at the initial operation. Better prognosis can be expected by aggresive surgical treatment for resectable intraperitoneal seeding.

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