A CASE OF EXTRA-MURAL GASTRIC SMOOTH MUSCLE TUMOR WITH THIN PEDICLE

This paper describes a case of pedunculated gastric smooth muscle tumor. An asymptomatic 46-year-old man was pointed out to have a huge abdominal tumor in the left upper quadrant of the abdomen at an annual medical examination. The patient was admitted to the hospital for examination. Abdominal CT scan and MRI visualized a solid tumor with scattered small portions internally which seemed like hemorrhagic foci. The solid tumor, which was not demarcated from the spleen, was located in the left upper abdominal cavity. Abdominal ultrasonography revealed strong internal dot echoes, but ultrasonographic Doppler examination did not indicate rich blood supply in the tumor. Celiac angiogram showed a hypervascular huge tumor which was mainly fed by dilated splenic artery. Laparotomy proved that the tumor was well circumscibed and located between the stomach and spleen. The tumor, which was extirpated with small area of adherent gastric wall, was 15cm in maximum diameter with homogeneous yellowish solid section. There was no metastatic lesion. Histological examination revealed the tumor consisted with smooth muscle of spindle shaped cells with few mitosis. The tumor was determined to be originated in the gastric wall, because the tumor was continuous with muscle layer of the stomach wall by thin stalk (0.3cm).