Tumors of the stomach

This collective review includes all available case reports of smooth muscle (stromal) tumors of the stomach in the world literature from 1762 to 1996. It updates our previous review from 1767 to 1959. Overall, we identified 2189 patients with leiomyoma (LM) and 1594 with leiomyosarcoma (LMS). The peak age of incidence of LM was 50 to 59 years, while LMS was most frequently seen between ages 60 and 69. Women were more likely to develop LM, and men more commonly presented with malignant smooth muscle tumors of the stomach. Concerning the patterns of growth, LMs were more likely to grow intraluminally (endogastric), whereas LMSs were predominantly exogastric. The most common site of LMs was on the anterior or posterior wall of the body of the stomach; LMSs were most likely found along the greater curve. The presenting symptoms of both types of smooth muscle tumors were similar; in decreasing order of frequency they were bleeding, pain, palpable mass, and weight loss. Interestingly, there was no correlation between the size of the tumor and signs or symptoms of bleeding, pain, weight loss, or ulceration, although patients with LMSs were more likely to report weight loss than patients with benign tumors. For LMS, there seemed to be no correlation between tumor size or location and rate of metastasis, although the tumors that grew in a dumbbell shape (i.e., both intraluminally and extraluminally) had a higher frequency of metastasis than other growth patterns. Overall, the rate of metastasis at diagnosis was 35.4%, with the liver, spleen, and regional lymph nodes the most common sites.