Gastric leiomyoblastoma: three interesting cases

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Leiomyoblastoma represents a distinct entity among gastric smooth muscle tumors, differing from typical benign and malignant variants.
• Its unique histological features, though characteristic, have historically posed diagnostic challenges for pathologists.

Observation:

• The recognition of leiomyoblastoma is crucial during surgical planning, as it dictates the appropriate operative strategy.
• Per-operative frozen section diagnosis is essential for accurate intraoperative assessment.

Findings:

• Enucleation alone is insufficient for leiomyoblastoma treatment.
• Wide local excision, often without lymph node dissection, is frequently adequate for curative resection.
• Extensive radical surgeries do not appear to improve survival rates.
• Total gastrectomy is reserved for cases with multiple lesions or recurrence.

Implications:

• Accurate diagnosis and tailored surgical management, including consideration of metastasis excision, can lead to favorable patient outcomes.
• Prognosis is best determined by integrating clinical presentation with histological findings.
• Early and precise diagnosis influences surgical decisions, potentially enabling curative resection even in advanced cases.