Calcified gastric leiomyoma.

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The purpose of this communication is to present a case of large leiomyoma of the stomach containing extensive calcium deposits easily visible on the roentgenogram. Mention has been made (1, 3, 4) of the frequent occurrence of microscopic calcification in leiomyomata of the stomach, particularly in the central portions of the mass, and it would seem that more of these tumors should produce calcium sufficient for roentgenographic visualization. Actually, however, grossly calcified gastric leiomyomata are exceedingly rare. A review of more than fifty articles on smooth-muscle tumors of the stomach revealed a single case similar to the one to be recorded here, that of Heitz (2), reported in 1902. His description (in part) follows: “The tumor lies in the posterior wall .... It is adjacent to the middle of the lesser curvature and it raises up the serosa over the posterior side of the lesser curvature behind the gastro-hepatic ligament in the lesser peritoneal sac. It produced no elevation into the interior of the stomach, and the mucous membrane is normal over it. The tumor was the size of a nut, very hard, giving a clear sound to percussion. Sectioned through its middle, it was found to be formed entirely of a calcareous substance covered by a thin serosal membrane. In the posterior part, however, the calcareous granulations were not confluent and were simply disseminated in a hard, apparently fibrous tissue. A small piece from this part was decalcified with picric acid and embedded in paraffin for the histologic examination. The sections show here and there small calcium masses strongly colored by hematoxylin. The framework of the tumor is formed by abundant and close-packed connective tissue with rare blood vessels. At certain points, smooth muscle cells can be recognized with their elongated nuclei, but fibrous tissue predominates. In résumé, the tumor is fibrous, secondarily calcified, and grew at the expense of the smooth muscle tissue in the tunica muscularis of the stomach.” The size, the degree of cytoplasmic degeneration, and the extent of calcification of the tumor in our patient indicate that it had been in existence for a long time, an assumption which Heitz made in his case. Case Report A. B. C., aged 58, a British West Indian Negro employed as a post-office printer, was admitted to Presbyterian Hospital (New York) on June 19, 1947, complaining of nausea, vomiting, weakness, and low-grade fever. Present Illness: The patient had been in good health until one month earlier, when he experienced a “falling off” of appetite, which increased progressively and was associated with a 15-pound weight loss. Three weeks before admission he had received an injection of influenza-pneumococcus vaccine (0.5 c.c.) for “sinus trouble.” This was followed shortly by transient nausea, mild malaise, chilly sensation, sweating, and a rise of temperature to 102°.