Primary Large Exophytic Leiomyosarcoma of the Stomach: A Case Report with Review of Literature

Abstract

Gastric leiomyosarcoma accounts for 1% of all gastric tumors. This type of tumor typically arises from the muscularis propria and is most often found in the body, fundus, cardia, and pyloric antrum of the stomach. Gastric leiomyosarcoma commonly presents as a polypoidal mass, exophytic mass, or ulcerative mass. The primary symptoms include bleeding leading to hematemesis, anaemia, abdominal pain, weight loss, and the presence of an abdominal mass. Effective diagnostic modalities include endoscopic ultrasonography, contrast-enhanced CT scan, and MRI. Immunohistochemically, the tumoral cells in gastric leiomyosarcoma show positive immunoreactivity to smooth muscle actin and desmin while testing negative for CD117 (C-kit) and CD34. The most effective treatment is complete surgical resection with negative margins, typically achieved through either open or laparoscopic partial gastrectomy. We report the case of a 57-year-old male who presented with a large mass in the epigastric and left hypochondriac region. Diagnosis was confirmed via CT scan of the abdomen, and histopathological examination verified a high-grade gastric leiomyosarcoma.