Spontaneous Regression Of Disseminated Gastric Leiomyoblastoma: A 29-year Follow-up
American Journal of Gastroenterology 75(4): Apr 1981; 294-298
View Original Source →Abstract
The case report of a man aged over 60 years with a round tumour about 5 centimeters in diameter in his stomach for over four years which was unchanged. Because of ankylosing spondylarthritis the patient was not suitable for gastroscopy and because of stenocardia the risk was too high for the laparotomy. Therefore PAD was not available. The tumour disappeared suddenly leaving a slight scar. The patient died one year later of pulmonary embolism. At the autopsy a round depression at the lesser curvature of the stomach was noticed, however neoplastic cells could be detected. There were no metastases. It seems to the writers that there had been a benign polypus which necrotized, and the scar underwent malignant degeneration.
Case Details
Personal Characteristics
26-year-old black male
Clinical Characteristics
Painless hematemesis, epigastric distress, massive upper gastrointestinal bleeding, left subphrenic abscess, melena, large mass in the left upper quadrant
Remission Characteristics
Survived 29 years since the diagnosis was first documented
Treatment & Mechanisms
Proposed Remission Mechanisms
Limited malignancy potential of the tumor, increase in immunological resistance, operative trauma, postoperative infection
Clinical Treatment
Incomplete excision of the primary, blood replacement, immediate exploration, excision for biopsy, gastric defect closure, omental implant excision, abscess drainage, gastric fistula healing, surgery via a thoracoabdominal approach, excising the greater curvature of the fundus and body of the stomach with the spleen, thoracotomy and drainage
Additional Notes
The patient received no adjuvant therapy. He was re-admitted several times due to recurring symptoms. He refused operation multiple times. His postoperative course was stormy and complicated by an infected hemothrax. He was always found to be in excellent health by his personal physician and gained considerable weight. Interval films of the abdomen between the period 1958-1972 revealed a progressive increase in the calcific deposits throughout the entire abdomen. Films from 1972-1979 reveal no change which represents a static and controlled course.