[Myoid tumors of the stomach. Our experience]

The authors analyse the incidence of myoid tumours of the stomach in comparison to bowl cancer as a whole and identify the different anatomopathological varieties (benign leiomyoma, leiomyosarcoma and Martin-Stout's bizarre leiomyoma). Symptoms are usually subtle and development slow: important factors are the site of onset (antro-pyloric in 60% of cases, body 25% and cardias 15%), the type of tumour growth (intra- or extraluminal or mixed) and tumour size which may sometimes be considerable. Four categories of patients are identified on the basis of symptoms shown: a) asymptomatic (chance diagnosis), b) aspecific (vague symptoms such as epigastralgia, dyspepsia, ecc.), c) symptomatic (presence of abdominal mass, chronic anemia, ecc.), d) complicated (onset of complications the most frequent of which is acute hemorrhage). The clinical data reported here refers to 4 patients (3 males and 1 female) aged between 53 and 75 years old. In one case diagnosis was made by chance, in 2 cases diagnosis followed acute hemorrhage of the upper digestive tract, and in the case of the woman clinical controls began following the finding of a voluminous abdominal mass. Diagnosis was based on traditional radiology and EGDscopy, as well as ultrasonography and CT. Treatment was surgical in all cases (two enucleations of the lesion and two atypical gastric resections). In the light of the authors' personal experience and data reported in the literature, the discussion focuses attention on the problems of diagnosis and therapy, in particular the various options facing the surgeon in the form of operating tactics.