Gastric adenocarcinoma appearance in leiomyoma: A case report

Highlights • Gastric adenocarcinoma arising from a leiomyoma which is diagnosed by pathological evidence as heterotopic glands carcinoma within it. • Pathological evidences diagnosed heterotopic gastric glands within the leiomyoma, then adenocarcinoma arose from the heterotopic gastric glands. • This is the first report that describes a case of gastric adenocarcinoma arising from leiomyoma.
Introduction We experienced an extremely rare case of gastric adenocarcinoma wrapped by leiomyoma. Presentation of case A 65-year-old man had an abnormality (filling defect) of the upper gastrointestinal series in his first medical checkup five years prior. Esophagogastroduodenoscopy detected a 10 mm submucosal tumor-like lesion in the greater curvature of the upper gastric remnant body. Despite repeated biopsy from the lesion, there was no sign of malignancy. A delle was observed on the top of the tumor at another visit five year after the first and a biopsy specimen revealed poorly differentiated adenocarcinoma. Therefore, laparoscopic gastrectomy was performed. Histological assessment revealed a 28 × 22 mm elevated lesion with a slight depression. Microscopically, papillary adenocarcinoma was observed at the submucosa with a solitary heterotopic gastric gland adjacent to the lesion. The final diagnosis was papillary adenocarcinoma arising from a solitary heterotopic gastric gland in the leiomyoma. No recurrence has occurred during a follow-up of two and a half years after surgery. Conclusions This is the first report of gastric adenocarcinoma arising from a submucosal tumor.