SMOOTH MUSCLE TUMORS OF THE GASTROINTESTINAL TRACT

Abstract

The clinicopathologic features and management of the smooth muscle tumours of the gastrointestinal tract vary widely. This review analyses the clinical symptoms and signs, radiological tests, the results of pathologic examination of these tumors and determines the factors that affect prognosis. We investigated the tumour size, histologic grade, association with gastrointestinal bleeding, operative procedure, age, gender and tumour necrosis of 12 patients with smooth muscle tumours (SMT) of the gastrointestinal tract retrospectively. Between 1985 and 1996, operations were performed on the 12 SMT-oesophageal 1, stomach 2, intestinal 6, colonic 1, rectal 2. The most common symptoms and signs were gastrointestinal bleeding in 6 (50%) of the patients and weight loss in 4 (33.3%). Tumours were classified as leiomyoma 3, low-grade leiomyorsarcoma 5, and high-grade leiomyosarcoma 4, according to the cellular atypia and mitotic rate. According to the tumour size and mitotic activity, a statistical significance had been found between leiomyoma and leiomyosarcoma. One patient died in the early postoperative period due to sepsis, and the other died of liver metastasis during the 3rd month of the follow-up period. Smooth muscle tumors are considered to be the diagnosis in the patients who had episodic gastrointestinal bleeding, weight loss, and abdominal pain of unknown origin. Surgical cure is possible in 2/3 of the patients and leiomyosarcomas usually more than 5 cm should be resected widely such as gastrectomy or abdomino-perineal resection.