胃内腔へ浸潤した後腹膜原発平滑筋肉腫および平滑筋芽腫の1剖検例

Abstract

A 70-year-old woman complaining of nausea was admitted to our hospital for further examination of a large abdominal tumor. CT scan, MRI and Ultrasonography revealed a large mass adjacent to the left kidney, spleen and pancreas. Angiography showed a tumor stain mainly fed by the dorsal pancreatic artery. Although radical tumorectomy as well as splenectomy was performed, complete removal of the tumor was not successful because of the marked adhesion that easily caused critical bleeding by surgical manipulation. In addition, 2 kinds of chemotherapy conducted after surgical treatment showed little efficacy, resulting in the rapid growth of the locally recurrent lesion. Finally, the formation of tumor thrombus in the inferior vena cava was followed by its direct invasion to the stomach with severe ulceration causing refractory bleeding. Consequently, she died of multiple organ failure caused by repeated upper gastrointestinal bleeding. Autopsy revealed a retroperitoneal tumor consisting of leiomyosarcoma as well as leiomyoblastoma with pathologically high malignancy.