Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2019; 7(21): 3575-3582
Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3575
Leiomyosarcoma of the stomach: A case report
Wen-Zhe Kang, Li-Yan Xue, Yan-Tao Tian
Wen-Zhe Kang, Yan-Tao Tian, Department of Pancreatic and Gastric Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Li-Yan Xue, Department of Pathology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Tian YT, Xue LY designed the report; Kang WZ collected the patient’s clinical data, analyzed the data and wrote the paper.
Supported by Beijing Municipal Science and Technology Commission, No. Z161100000116045; and National Natural Science Foundation of China, No. 81772642.
Informed consent statement: Consent was obtained from patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yan-Tao Tian, MD, Professor, Department of Pancreatic and Gastric Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Beijing 100021, China. tyt67@163.com
Telephone: +86-10-87787120 Fax: +86-10-87787120
Received: August 11, 2019
Peer-review started: August 11, 2019
First decision: September 9, 2019
Revised: September 19, 2019
Accepted: October 5, 2019
Article in press: October 5, 2019
Published online: November 6, 2019
Processing time: 88 Days and 4.4 Hours
Abstract
BACKGROUND

Leiomyosarcoma of the stomach is extremely rare, and only 13 cases have been reported in the literature. Before the advent of KIT immunohistochemistry, gastrointestinal stromal tumors (GISTs) were misdiagnosed as leiomyomas and leiomyosarcomas. Leiomyosarcoma rarely occurs in organs besides the uterus and is rarely located in the stomach.

CASE SUMMARY

A 57-year-old woman presented with the symptom of melena over a one-month period. She had suffered weight loss, weakness, nausea and vomiting for fifteen days. At a local hospital, computed tomography showed a very large mass in the stomach, and the results of endoscopic examination and histopathological diagnosis were unclear. She received transfusion therapy and was transferred to our hospital. Upon arrival at our hospital, the patient was anemic. She denied any family history and had no specific past history. No signs of pulmonary metastasis were found on chest radiographs. Magnetic resonance imaging and computed tomography confirmed a very large tumor in the stomach, and no visible signs of metastatic disease were found. On October 30, 2013, the patient underwent resection of the stomach tumor and did not undergo any adjuvant treatment. The margins were negative and she had an uneventful recovery and was discharged after 12 d. One year after surgery, the patient died at home, and the cause of death were gastrointestinal obstruction and malnutrition. During that time, she was treated with Chinese medicine but the effect was not ideal. Because of gastrointestinal obstruction, the patient did not receive any re-examination.

CONCLUSION

Surgical resection is the standard treatment for gastric leiomyosarcoma. The diagnosis of this tumor mainly depends on histopathological examination. This case may suggest the aggressive behavior and poor prognosis of this tumor.

Keywords: Leiomyosarcoma; Stomach; Case report; KIT; Gastrointestinal stromal tumor; Targeted next-generation sequencing

Core tip: Leiomyosarcoma of the stomach is extremely rare, and only 13 cases have been reported in the literature. We herein report one case and review the literature. This case might contribute to improving our understanding of the etiology, diagnosis, treatment strategies, and outcome of gastric leiomyosarcoma. This report can also serve as a reminder to gastroenterologists, surgeons, and pathologists who encounter gastric leiomyosarcoma in their clinical practice.