Gastric epithelioid leiomyoblastoma. Description of a clinical case and considerations]

The authors present one case of gastric epithelioid leiomyoblastoma making some clinic considerations. Denominated also bizarre leiomyoblastoma or epithelioid leiomyoma or leiomyosarcoma, it is a rare malignant neoplasm of the stomach originating from mesenchyma. Symptomatology is extremely variable, often with asymptomatic; that gives a difficult pre-operative diagnosis. The most useful diagnostic tests are: ultrasonography and computed tomography scan; they allow besides the valuation of eventual metastasis and they are absolutely necessary in the follow-up of the patient. Macroscopically is a multilobular neoplasm, capsulated. Histologically is characterized with round cells with a central nucleus and plentiful clear cytoplasm. The principal elements about to determinate the malignity are the mitotic index and the cellularity. Surgery is the elective therapy. It consists in the complete removal of cancer with minimal exeresis of healthy tissue. Chemotherapy and radiotherapy haven't an unequivocally efficient role. Prognosis of the tumors with 5 years survival is inferior to 50%. Malignant prognosis is in patients with metastasis.