A Case of Gastric Leiomyoma Accompanied by Hemoperitoneum Successfully Treated with Transcatheter Arterial Embolization Followed by Elective Surgery

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  • 腹腔内出血で発症しTAEにて止血後待機的に切除した胃平滑筋腫の1例
  • 症例 腹腔内出血で発症しTAEにて止血後待機的に切除した胃平滑筋腫の1例
  • ショウレイ フクコウ ナイシュッケツ デ ハッショウ シ TAE ニテ シケツ ゴ タイキテキ ニ セツジョ シタ イ ヘイカツ キンシュ ノ 1レイ

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Abstract

A 65-year-old male visited a local doctor because of an abrupt onset of epigastralgia, and was brought into our hospital by ambulance because he went into a pre-shock state. An abdominal contrast-enhanced CT scan showed a low density mass with hematoma located near the greater curvature of the lower gastric corpus and a small amount of fluid collection in the abdominal cavity. The patient was diagnosed with hemoperitoneum caused by rupture of a gastric submucosal tumor. Urgent transcatheter arterial embolization (TAE) was performed, and hemostasis was obtained by embolizing the right gastroepiploic artery. Partial gastrectomy was conducted two weeks after TAE. The histopathological findings confirmed the diagnosis of gastric leiomyoma, which showed spindle-shaped cells arranged in an interlacing pattern with neither mitosis nor nuclear atypia. Immunostaining revealed that these cells were negative for c-kit, CD34, S-100 and DOG1, but were positive for α-SMA, vimentin and desmin. We herein present an extremely rare case of gastric leiomyoma accompanied by hemoperitoneum, which was successfully treated with TAE followed by elective surgery.

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