Primary Gastric Leiomyosarcoma in Young Revealed by a Massive Hematemesis
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Primary Gastric Leiomyosarcoma in Young Revealed by a Massive Hematemesis Mehdi Soufi & Abdelkader Errougani & Rachid M. Chekkof
Published online: 2 September 2009 # Humana Press Inc. 2009
Abstract Introduction Leiomyosarcomas are one of the most common soft tissue sarcomas, usually seen in deep, soft tissues of the extremities and retroperitoneum. Leiomyosarcoma primarily involving the gastrointestinal tract is uncommon. We present here a rare case of gastric leiomyosarcoma revealed by a massive hematemesis in a young woman. Case Report We present a case of primary gastric leiomyosarcoma in a 16-year-old woman who presented with massive hematemesis. Computed tomography scan examination revealed a tumor mass located in the anterior wall of the upper body and protruding into the lumen. The patient was treated by subtotal gastrectomy. The histological examination confirmed the diagnosis of leiomyosarcoma of the stomach. Discussion Primary stomach leiomyosarcoma is rare, accounting for only 1% of gastric tumors. Endoscopic ultrasound and biopsy are helpful in establishing the diagnosis. Surgical resection is the treatment of choice for gastric leiomyosarcomas. Keywords leiomyosarcoma . stomach . massive hematemesis . gastrectomy
Introduction Sarcomas are a heterogeneous group of rare tumors arising predominantly from the embryonic mesoderm [1]. They are responsible for approximately 1.15% of cancer-related M. Soufi (*) : A. Errougani : R. M. Chekkof Surgery E Department, IBN Sina, Rabat, Morocco e-mail: [email protected]
deaths [1]. Soft tissue sarcomas can occur anywhere in the body, but most originate in an extremity (59%), the trunk (19%), the retroperitoneum (15%), or the head and neck (9%) [2]. Gastric sarcoma is rare, accounting for less than 1–3% of all gastric malignancies. Approximately 50% of all gastrointestinal sarcomas develop in the stomach [3]. Currently, more than 50 histological types of soft tissue sarcoma have been identified, but the most common types are malignant fibrous histiocytoma (28%), liposarcoma (15%), and leiomyosarcoma (12%) [3]. Primary stomach leiomyosarcoma is rare, being responsible for a mere 1% of gastric tumors [4]. The diagnosis of mesenchymal tumors of the digestive tract is usually delayed. Gastric leiomyosarcoma is generally common among adults in their fifties and is rare among young adults. Both men and women are at risk of getting this disease. Hence, there is no predominance of sex, especially towards the age of 60. The increase of the risk in young adults is rare [4]. They characterize themselves by a silent evolution and exophytic development. The symptomatology is poor; the sarcoma is most often revealed by an occult bleeding or abdominal mass. A shock state with a massive hematemesis is unusual in young adults [3]. Esophagoduodenoscopy is the established method for evaluating the gastrointestinal tract. For stomach tumors, upper endoscopy with endoscopic ultrasonography and biopsy are important diagnostic tests to distinguish adenocarcinoma from mesenchymatous
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