胃癌と共存した胃平滑筋芽細胞腫の1例

Leiomyoblastoma with Cancer of the Stomach, Report of a Case

　胃癌と胃肉腫の併存例は非常にまれである．とりわけ胃平滑筋芽細胞腫との共存は本邦報告例によれば，本症例を加えてもわずかに5例にすぎない．最近われわれは，胃角部から胃前庭部の小彎側のBorrmann 3型進行癌とこれより約1cm口側の胃体中部から下部の小彎側の平滑筋芽細胞腫を共存した症例を経験したので文献的考察を加えて報告する．

　The case of sarcoma of the stomach with a gastric cancer is extremely rare, especially the case of leiomyoblastoma is rare. Only five cases have been reported in Japan so far, including the present case.

　Patient: A 67 year-old man. His chief complaint was epigastrium discomfort. He was diagnosed to have leiomyosarcoma with a Borrmann 3 type gastric cancer before the operation. Macroscopic findings of the excised stomach revealed a Borrmann 3 type gastric cancer (8×7.5cm) in the lesser curvature area extending from the gastric angle to the pyloric antrum, and in addition, a submucosal tumor without an ulcer (3×3×2 cm) in the lower area of the lesser curvature below the middle part of the corpus ventriculi, 1 cm oral side of this cancer. As regards the histopathological examination, he was finally diagnosed to have leiomyoblastoma with a gastric cancer. Both tumors existed separately from each other, that is, their impaction was not observed. Metastasis to the other organs and lymph nodes was not observed. Mitosis, which is used histopathologically as an index of the malignancy of leiomyoblastoma, was observed. However, in general, leiomyoblastoma was considered to be a special type of low malignant sarcoma. The incidence of metastasis was low, it was observed in 7 out of 76 cases of leiomyoblastoma previously reported in Japan.

　Consequently, the prognosis of the present case is considered to be dependent upon whether the gastric cancer may recur or not.