A case of an unresectable second recurrent metastatic liver tumor of gastric leiomyosarcoma treated by PMCT and open MCT

Abstract

Gastrointestinal leiomyosarcoma usually results in repeated liver metastases or peritoneal disseminations during a long clinical course. Considering the therapeutic strategies for these liver metastases other than operative hepatic resection, percutaneous ethanol injection therapy (PEIT) or transcatheteric arterial embolization (TAE) may be not very effective due to the tumor's solidity and hypovascularity. Recently, microwave coagulonecrotic therapy (MCT) is becoming familiar as one of the strategies for liver tumors. We performed percutaneous MCT (PMCT) and open MCT consecutively for one case of an unresectable second recurrent metastatic liver tumor of gastric leiomyosarcoma and were able to control the growth of the tumor.In our present strategy for liver metastases of leiomyosarcoma, small metastases under 2 cm in diameter are treated by PMCT or open MCT, but for large metastatic tumors, hepatectomy should be chosen in cases in which operative curability can be expected. In terms of quality of life, it is possible to employ open MCT aggressively for huge metastatic liver tumors that can not be resected for anatomical reasons.