Neoplasms arising from smooth muscle of the gastrointestinal (G-I) tract are uncommon, comprising about 1% of its nonspecific subjective symptoms and slow rate of growth. Leiomyosarcoma does not respond well to chemotherapy or radiation therapy.
Despite
this fact, if shows a good prognosis with only surgical excision. Forty-four cases of smooth muscle tumors of the GI tract operated on from 1983 to 1994 at the Dept. of surgery, Hanyang University Hospital, were analysed; there were 23
leiomyomas,
1
epitheloid leiomyoma, 17 leiomyosarcomas, and 3 epitheloid leiomyosarcomas. The tumors were located in the esophagus(n=4), stomach(n=22), jejunum(n=6), ileum(n=2), colon(n=3), rectum(n=1), mesentery(n=2), omentum(n=2), and pancreas(n=1). The
clinical
presentation varied according to the location of tumor, but abdominal pain and palpable mass were the most common presenting symptoms. The epitheloid leiomyosarcoma was the largest in size, and then the leiomyosarcoma, the epitheloid leiomyoma,
and
the
leiomyoma, in decreasing order. The mitotic index was higher in leiemyosarcoma than in epitheloid leiomyosarcoma. The postoperative 5-year survival rate of leiomyosarcoma was 56%, while in the case of local recurrence or distant metastasis, it
showed
only 25% of 1-year and 6-months survival rate. All three of the patients with epitheloid leiomyosarcoma survived during a follow-up period from 3 years to 9 years. It is recommended that, when patients visit with nonspecific clinical features,
the
physician devote more attention to discovering the hidden neoplasms.
The purpose of this article was to point out the possibility of the presence of this tumor despite its low incidence, and the necessity for it to be ruled out at an early stage-despite its nonspecific clinic symptoms-in order to obtain a better
prognosis through prompt surgical treatment.
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