Leiomyosarcoma of the stomach

Summary The literature is reviewed, and 10 cases of leiomyosarcoma of the stomach are presented. Nine of these were encountered during the 10-year period of 1948–58. The clinical features and roentgenologic diagnosis are discussed. Two cases were of microscopically benign leiomyomas that eventually metastasized. One case involved a gastric adenocarcinoma. A case with gastric fistula leading to the center of a large, necrotic, exogastric leiomyosarcoma is presented. There were 3 long-term survivals, 1 of five years and 2 of ten years. Emphasis is placed on the slow rate of metastasis and the excellent prognosis of long-term survival when the tumors are thoroughly removed.It is suggested that leiomyosarcoma be considered in those cases where (a) gastric tumor, or (b) gastric fistula, or (c) barium outside the confines of the stomach is radiogrphaically shown in the examination of the gastrointestinal tract, in patients whose clinical picture is one of (a) anemia secondary to blood loss, (b) vague epigastric complaints, and (c) long duration of symptoms.