Management of gastrointestinal smooth muscle tumors: seven years experience of a teaching hospital in Saudi Arabia.
BACKGROUND
Gastrointestinal (GI) smooth muscle tumors are a group of intramural GI tumors formerly known as leiomyoma and leiomyosarcoma. This retrospective study was made to review our experience in surgical management of GI smooth muscle tumors.


METHODS
The clinical records for patients with GI smooth muscle tumors during 1993-1999 were reviewed.


RESULTS
Ten tumors were located in stomach. Abdominal pain was the main presenting symptom followed by GI bleeding. The preoperative diagnosis was made by enhanced computerized tomography (CT) on eleven patients out of thirteen, while upper GI endoscopy with biopsy identified six tumors out of thirteen patients had the test. Tumors were treated by conservative excision in four and radical excision in fourteen. Histology was leiomyoma in six patients (with mitotic figures < 4 per 10 high power field) and leiomyosarcoma was found in twelve patients (with mitotic figures> 4 per 10 high power field). Median follow-up was 4 years. There was one recurrence for leiomyoma (size: 6 cm). All patients with leiomyosarcoma presented later with metastasis and died.


CONCLUSIONS
Size and mitotic activity of tumors are the main determinant factors. Enhanced CT remains the proper diagnostic tool.
Department of Surgery, College of Medicine & King Khalid University Hospital, Riyadh, Saudi Arabia.
S M
SM
Al Salamah
A Y
AY
El Keyali