胃平滑筋肉腫の1例―その頻度と臨床所見をめぐる考察

A CASE OF LEIOMYOMA OF THE STOMACH

Ⅰ．はじめに

　胃平滑筋腫および胃平滑筋肉腫は，今日それほど稀な疾患ではないが，本邦にとくに多い胃癌と鑑別すべき疾患として，臨床的および病理学的な検討が種々試みられている．われわれも最近巨大な腹部腫瘤，貧血および食思不振を主訴とし，精査の結果，胃平滑筋肉腫と診断され，手術により組織学的に確認しえた症例を経験したので報告する．

　Partient: a 59 year-old housewife.

　Chief Complaints: tumor in the abdomen, anemia and loss of appetite.

　Past History: encephalomalacia at 36, typhoid fever at 37 and resection of left breast cancer at the age of 49.

　Family History: none.

　Present History: since Sept. 1966, the patient noticed slight fever, with gradual appearance of chief complaints mentioned above. As a stomach tumor was suspected, she was referred to the authors' hospital for thorough examination.

　Course in the Hospital: the patient had slight anemia. No swelling of lymph-nodes was noticed. A tumor with uneven surface was found in the epigastrium, distinctly separated from adjacent organs. It moved freely on respiration and was not tender on palpation. The gastric juice was hypoaciditic, with decreased secretion. No tumor cell was found by cytologic examination.

　Roentgenological and Endoscopic Findings: the stomach was pushed aside to left, and barium was seen to enter into the tumor itself by way of a fistula in the lower gastric corpus. It was clear that a cyst was formed within the neoplasm. Endoscopically, except fistula, no abnormality, such as bleeding or bridging folds, was observed on mucosal surface.

　Operative and Pathological Findings: the tumor, the size of a child's head, weighed 985 gr, with its surface well capsulated all over. The surface of the mucous membrane was smooth.

　Necrotic tissues of a cyst, about 10 cm in diameter, was found inside the tumor. Pathologically, it proved to be a leiomyoma of the stomach.