A CASE OF LIVER RESECTION FOR METACHRONOUS LIVER METASTASIS OF LEIOMYOSARCOMA OF THE STOMACH

Abstract

A case involved a 63-year-old women who underwent a distal gastrectomy for a gastric leiomyosarcoma in February 1994, a liver tumor 3 cm in size was pointed out with abdominal ultrasonic study but she did not receive any treatment. She was admitted because of an enlargement of the liver tumor confirmed by abdominal CT study in January 1995. An abdominal ultrasonic study and angiography revealed metastatic liver tumor 5 cm diameter in the right-posterior lobe. She underwent a hepatectomy for the right lobe. Histopathological diagnosis was liver metastasis of the gastric leiomyosarcoma. There have been 24 reports of hepatectomy for liver metastasis of gastric leiomyosarcoma in Japan. Among them, 19 cases were of metachronous liver metastasis, in which a mean duration until diagnosis of liver metastasis was 38.3 months and the tumor diameter was 9.8 cm in average. The duration of mean survival time after resection of the liver metastasis was 34.8 months. In this case the primary lesion was 5.0×3.9 cm in size, number of mitotic cells was 16.9/mm2, and Ki-67 L.I. was 12.5. The number of mitosis was very high that might suggest a high proliferation potential of the tumor. It is though that Ki-67 L.I. is important as a prognostic factor of gastric leiomyosarcomas.