A leiomyosarcoma is a malignant tumour of smooth muscle. It is the malignant counterpart to a leiomyoma. They are mainly found in smooth muscle of the gut or myometrium. In the stomach, leiomyosarcoma is the second most common non-epithelial malignancy, and it occurs more frequently in men. The presentation of gastric leiomyosarcoma may be with melaena and massive haematemesis.
Leiomyosarcomas spread locally and haematogenous spread occurs early; from the stomach, for example, metastatic spread is to the liver and lungs.
Treatment is by surgical excision of the primary lesion. If metastasis has occurred, then palliative chemotherapy is given. Whenever possible, radical resection for stomach leiomyosarcoma should be attempted - the 5 year survival rate is as good as 50% in some centres.
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