Smooth muscle neoplasms of the stomach

We reviewed the records of 31 patients with smooth muscle tumors of the stomach seen at the First Surgical Department, Medical School, University of Athens, Greece, between the years 1961 and 1981 with special emphasis on the clinical data, diagnosis, and pathology. The majority of patients were symptomatic and were preoperatively diagnosed by radiology and/or endoscopy, but accurate histologic diagnosis was obtained in only three cases. The tumors varied in size, were relatively equally distributed throughout the stomach, and their management required 35 operations, consisting of 18 Billroth II gastrectomies, 15 local excisions, and two total gastrectomies. Histologically, the tumors proved to be leiomyoma in 23 cases, leiomyosarcoma in ten, and leiomyoblastoma in two. The difficulty of histologic classification in the absence of metastasis is clearly shown by the fact that three tumors recurred and were subsequently characterized as leiomyosarcoma one to three years after they were initially classified as leiomyoma.