Gastric leiomyoblastoma: three interesting cases

The leiomyoblastoma of the stomach has emerged as a separate entity different from the well known benign and malignant gastric tumours of smooth muscle origin. The histologic picture is very typical but has puzzled many pathologists in the past. It is important to consider the possibility of this tumour at operation because it will influence the type of operation to be carried out. Even with seeminly hopeless spread a curative resection is often possible. Per-operative frozen section diagnosis is imperative. Enucleation alone is inadequate. Wide local excision without removal of the regional lymph nodes is often sufficient. More radical operations have no apparent effect on survival. A total gastrectomy is only indicated in cases of multiple localisations or recurrences. Primary and secondary excision of metastases should be considered. Prognosis is relatively good and is best evaluated by a combination of clinical and histologic criteria.