Gastric leiomyosarcoma: A clinicopathological review

Objective: To report our experience of eight patients with primary gastric leiomyosarcoma. Design: Retrospective study. Setting: Teaching hospital, Taiwan. Subjects: 8 patients who presented with primary gastric leiomyosarcoma between 1986 and 1990. Main outcome measures: Endoscopic, radiological, and histopathological features, DNA ploidy, and outcome. Results: Abdominal pain and gastrointestinal bleeding were the most common presenting symptoms. In 5 of the 7 patients who had endoscopy preoperatively a diagnosis of submucosal tumour was made, but a definite diagnosis of leiomyosarcoma was made in only 3. A provisional diagnosis of leiomyosarcoma was made in 3 of the 4 patients who had computed tomography. All patients underwent some form of gastric resection ranging from palliative resection to total gastrectomy. Patients in whom the tumour had invaded adjacent organs had a poor prognosis. Histopathological grading of tumours correlated well with DNA ploidy. Conclusion: Both histopathological grading and DNA ploidy could be helpful objective prognostic criteria in patients with primary gastric leiomyosarcoma.