Eighteen-year survival of unresected leiomyoblastoma of the stomach with liver and lymph node metastases.

A case of gastric leiomyoblastoma with liver and lymph node metastases occurring in a 31-year-old man, who has been alive with the tumor but without symptoms for more than 18 years after only an exploratory laparotomy without resection, is reported. On laparotomy, the liver metastasis and paragastric and para-aortic lymphadenopathies made it impossible to resect the stomach with the tumor. A diagnosis of malignant leiomyoblastoma was confirmed by incision of the liver and paragastric lymph nodes. Postoperative chemotherapy with mitomycin C and cyclophosphamide was performed for 6 months. As demonstrated by roentgenography, echography and computed tomography, the size of the tumor has remained almost identical for an 18-year period. Histologically, the low mitotic rate of the tumor in this case is considered primarily responsible for the long survival of the patient. A review of the records has revealed that our patient is the longest survivor to have unresectable gastric leiomyoblastoma with liver and lymph nodes metastases.