1/128. Laparoscopic ultrasound guidance for laparoscopic resection of benign gastric tumors.Laparoscopic excision of gastric leiomyoma is technically feasible and safe, but it may fail to localize the exact placement of the lesion because of the lack of tactile sensitivity. The authors present two cases of small gastric leiomyomas that were resected by a totally laparoscopic approach, assisted with intraoperative laparoscopic ultrasonography because the lesions could not be palpated. A gastric wedge resection with tumor-free margins was performed with an endostapler device. Use of a harmonic scalpel to divide the gastroepiploic vessels facilitated the laparoscopic procedure.- - - - - - - - - - ranking = 1keywords = leiomyoma (Clic here for more details about this article) |
2/128. Pedunculated exogastric leiomyosarcoma: case report and brief literature review.A case report and review of the literature on pedunculated exogastric leiomyosarcomas are presented. Although about one-fourth of the stromal tumors (common leiomyomas and leiomyosarcomas) of the stomach grow in an exogastric configuration, pedunculated exogastric leiomyosarcomas are extremely rare. At present there is no evidence of intraperitoneal seeding from exogastric leiomyosarcomas. Consequently, a local resection with an adequate margin is sufficient when no invasion to the adjacent structures, is observed.- - - - - - - - - - ranking = 0.5keywords = leiomyoma (Clic here for more details about this article) |
3/128. Laparoscopic resection of large leiomyomas of the gastric fundus.Two patients with a large leiomyoma arising from the gastric fundus underwent laparoscopic resection. In case 1, the tumor was located in the anterior wall of the gastric fundus. To prevent stenosis and preserve the volume of the residual stomach, intragastric resection was adopted. The tumor was markedly and resected with laparosonic coagulating shears with a 1-cm safety margin. In case 2, a large tumor was detected in the duodenal bulb. Serious hemorrhage mandated emergency resection. The tumor originated from the posterior wall of the fundus. Attempts at reduction with the forceps failed. Reduction by digital manipulation via laparoscopic port sites was successful. An endostapler was used to resect the tumor and close the anterior wall. Both patients recovered uneventfully.- - - - - - - - - - ranking = 2.5keywords = leiomyoma (Clic here for more details about this article) |
4/128. An undescribed coexistence of a subserosal exophytic gastric leiomyoma with a serous microcystic pancreatic adenoma.We present the case of a 66-year-old woman with complaints of odynophagia but normal gastro-oesophagoscopic findings. On computed tomographic examination, a presumptive diagnosis of a cystic liver tumor and a microcystic pancreatic adenoma was made. Histopathological examination of the hepatic mass, however, revealed a subserosal exophytic gastric leiomyoma. Considerations to avoid the potential pitfall of diagnosing an exogastric leiomyoma as a liver tumor are emphasized. Moreover, the unique association of an exogastric leiomyoma and a serous microcystic pancreatic adenoma is discussed.- - - - - - - - - - ranking = 3.5keywords = leiomyoma (Clic here for more details about this article) |
5/128. Inflammatory fibroid polyp and helicobacter pylori. Aetiology or coincidence?OBJECTIVE: To evaluate our incidence of inflammatory fibroid polyps, compare our experience with that of others, and to analyze the possible pathophysiological and aetiological factors. DESIGN: Retrospective review. SETTING: teaching hospital. MATERIAL: All histopathological slides of the gastrointestinal tract. MAIN OUTCOME MEASURES: incidence and treatment in our Medical Center and elsewhere. RESULTS: We could find only one case of inflammatory fibroid polyp, an estimated incidence of 1/4000. Between 1987-1996 only 331 were reported elsewhere, most of which (293, 88.5%), were located in the stomach. CONCLUSION: Primary mucosal damage can expose the stroma to several irritants (chemical, mechanical and biological), that may subsequently cause inflammatory fibroid polyps in certain people.- - - - - - - - - - ranking = 39.725746729613keywords = fibroid (Clic here for more details about this article) |
6/128. Hemorrhagic gastric glomus tumor mimicks a leiomyosarcoma on both transabdominal and endoscopic ultrasonography: case report.glomus tumor is a benign tumor that arises from the modified smooth muscle cells of the glomus body and usually occurs in the skin, particularly in the nail-beds and fingertips. Gastric glomus tumor is a rare gastric submucosal tumor. Endoscopic ultrasonography (EUS) is useful in differentiating the gastric submucosal tumors, such as leiomyoma, leiomyosarcoma, lipoma, ectopic pancreas and glomus tumor. On sonography, gastric glomus tumor appears as a homogeneous hypoechoic or a heterogeneous low echoic pattern mixed with internal high echoic spots. Here, we describe an unusual sonographic figure of a hemorrhagic gastric glomus tumor on both EUS and high-resolution transabdominal ultrasonography (TAU). This tumor was located in the gastric muscular layer. Sonographic examination revealed a heterogeneous echogenicity with hyper- and anechoic areas, which mimicked the echoic pattern of gastric leiomyosarcoma.- - - - - - - - - - ranking = 0.5keywords = leiomyoma (Clic here for more details about this article) |
7/128. hemoperitoneum secondary to exophytic leiomyoma: report of a case.We report herein the case of a 63-year-old male with hemoperitoneum secondary to exogastric leiomyoma. The patient had been receiving anticoagulation therapy for a cerebral embolism and complained of sudden, severe abdominal pain. A sonogram and computed tomography scan showed an exogastric mass and massive ascites. A peritoneal puncture proved the presence of an intraperitoneal hemorrhage. An emergency laparotomy revealed a pedunculated bleeding tumor, thus confirming the preoperative diagnosis of a ruptured exogastric tumor. A microscopic analysis of the excised tumor demonstrated gastric leiomyoma. Other authors have reported hemoperitoneum secondary to gastric myogenic tumors, but no cases of leiomyomas could be found in the literature.- - - - - - - - - - ranking = 3.5keywords = leiomyoma (Clic here for more details about this article) |
8/128. A case of gastrointestinal stromal tumor of the stomach.In a 55-year-old man, a tumor about 3 cm in diameter was detected in the upper abdomen by abdominal ultrasound screening during follow-up of chronic hepatitis c discovered in 1990. There were no symptoms and no abnormalities on physical examination. Tests for tumor markers were negative. By barium meal and gastroscopy, submucosal tumor was found on the lesser curvature of the stomach, with bridging fold in the absence of central ulceration. biopsy revealed no tumor tissue. Under the diagnosis of submucosal tumor of the stomach, either a leiomyoma or leiomyosarcoma, partial resection of stomach was performed. Direct invasion of the surrounding organs, lymph node metastasis or distant metastasis was not observed grossly in the operation. Histologic examination of the resected specimen revealed proliferation of spindle cells and oval cells in an interlacing pattern. immunohistochemistry for CD34, vimentin and c-kit protein was strongly positive, while smooth muscle actin, S-100 protein, desmin and p53 protein were negative. The proliferating cell nuclear antigen index was about 50%, while the MIB-1 index was < or = 1%. From these findings, this tumor was diagnosed as a gastrointestinal stromal tumor of the uncommitted type.- - - - - - - - - - ranking = 0.5keywords = leiomyoma (Clic here for more details about this article) |
9/128. Surgical management of gastrointestinal stromal tumors of the stomach.BACKGROUND: gastrointestinal stromal tumors (GISTs) are rare tumors of the GI tract with varying degree of dignity and prognosis. Intramural or extragastral growth of gastric GISTs is associated with diagnostic difficulties and uncertainty about the type and extent of surgical therapy. Based on our experience, we tried to formulate management guidelines for gastric GISTs. methods: Five patients with gastric GIST (36-85 years old) underwent subserosal excision with subsequent B-II resection (1x), full-thickness partial gastric resection (2x), gastrotomy with submucosal excision (1x), or gastrectomy for carcinoma with an incidental finding of a leiomyoma (1x). RESULTS: Tumor size ranged from 2x2x1 cm to 9x6x4 cm. These tumors were classified as epithelioid leiomyosarcoma (1x), GIST (3x), or leiomyoma (1x). The prognosis of risk ranged from no risk (leiomyoma) to low-malignancy (leiomyosarcoma) depending on tumor size and mitotic index. No recurrent disease has been noted so far during follow-up ranging from 3 months to 6 years. CONCLUSIONS: Staging of gastric disease should include the probability of gastric GIST. Surgical resection is the therapy of choice for potential malignant GISTs to ensure a local radical removal. Metachronic metastases should be resected if possible. Depending on tumor stage and prognostic parameters, an individual follow-up with endoscopic and radiologic examinations is recommended. Further studies should be undertaken to elaborate prognostic determinants and stage-adapted treatment.- - - - - - - - - - ranking = 1.5keywords = leiomyoma (Clic here for more details about this article) |
10/128. Endoscopic features of smooth muscle tumors in children with AIDS.BACKGROUND: Smooth muscle tumors are the second most common malignancy encountered in children with acquired immunodeficiency syndrome (AIDS). This study reviewed the incidence and endoscopic appearance of smooth muscle tumors in the gastrointestinal tract of children with AIDS undergoing endoscopy. methods: Retrospective review of all endoscopic records (n = 70) of children with AIDS from August 1988 to December 1997 at a tertiary care inner city hospital. RESULTS: Three children with advanced AIDS (4%) were found to have smooth muscle tumors, all of which had the typical appearance of submucosal nodules with central ulceration. Some were hemorrhagic. They measured less than 1 to 4 cm in diameter. Two children had multiple tumors. All lesions except for one were located in the colon. Colonic biopsies revealed a leiomyoma in one patient and a smooth muscle tumor of uncertain malignant potential in another. The forceps biopsy of the single gastric mass was not deep enough to make the diagnosis of a smooth muscle tumor. A nonmalignant smooth muscle tumor grew from less than 5 mm to more than 4 cm in 1 year and was removed surgically. All three children are alive without any evidence of local spread or distant metastases despite no specific therapy for the smooth muscle tumor. CONCLUSIONS: Smooth muscle tumors in the GI tract of children with AIDS are relatively common. Further study of the long-term outcome for children infected with the human immunodeficiency virus who have these lesions are needed to establish prognosis and management guidelines.- - - - - - - - - - ranking = 0.5keywords = leiomyoma (Clic here for more details about this article) |
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