Gastric leiomyoma and leiomyosarcoma - A case report

Diagnostic procedures, therapy and prognosis of gastric leiomyoma and leiomyosarcoma are discussed on the basis of two cases. Gastric leiomyoma and leiomyosarcoma become often symptomatic by causing massive upper gastrointestinal bleeding. Immediate operative interventions to stop bleeding are often mandatory. Intraoperatively it is nearly always impossible to differ between leiomyoma and leiomyosarcoma. Gastrectomy seems not to be superior to local resection or distal gastric resection. Leiomyosarcomas do not metastasis into lymph nodes; therefore systematic lymphadenectomy is not indicated. Adjuvant chemotherapy does not improve patients' prognosis. Gastric leiomyomas have a good prognosis, but gastric leiomyosarcomas (5 year survival rate: 19%) have a prognosis which is as bad as the prognosis of gastric cancer.