Minimally Invasive Endoscopic Treatment of Gastric Leiomyosarcoma: A Rare Case Report and Review of Literature

Abstract

Gui-Xiang Kong, Xiao-Lu Su, Xiao-Jun Huang

Background Since the c-kit was described in 1998, gastrointestinal LMS remains a relatively rare disease in the post-GIST era. Previous studies have reported that gastric LMS accounts for only 1% of gastric tumors. This report provides valuable endoscopic and endoscopic ultrasound data for rare diseases such as primary gastric leiomyosarcoma, which can add experience for clinical diagnosis to the current literature. Particularly, this case proved that the early-stage lesions can be treated with minimally invasive endoscopic treatment with high safety, good tolerance, and satisfactory clinical results.
Case Presentation A 63-year-old female patient visited our hospital mainly because of “epigastric pain and discomfort for 2 months.” After hospitalization, the relevant examinations were performed, and laboratory examination showed no obvious abnormalities. Abdominal contrast-enhanced CT found slight thickening of the gastric body wall. Ultrasonic gastroscopy revealed a round protuberant mass that originated from the muscularis mucosa on the great curvature of the gastric body, with a largest diameter of 16 mm. After full communication with the patient and exclusion of contraindications, the patient successfully underwent diagnostic endoscopic submucosal dissection (ESD) surgery. The postoperative pathological findings, immunohistochemical staining panel and molecular detection all improved that the mass was leiomyosarcoma. After 18 months of follow-up, the patient was in good condition, and there was no relapse on gastroscopy and abdominal enhanced CT.
Conclusion Gastrointestinal leiomyosarcoma can be successfully resected by minimally invasive endoscopic treatment with high safety, good tolerance, and satisfactory clinical results. This shows that ESD is an effective method for the treatment of these diseases and has promising prospects for clinical application.

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