S-68 A Primary Hepatic Leiomyoma in a Gastric Cancer Patient = S-68 A Primary Hepatic Leiomyoma in a Gastric Cancer Patient

다국어 초록 (Multilingual Abstract)

An asymptomatic, 57-year-old man without any significant medical history was referred to our hospital because of early gastric cancer and a hepatic mass. Esophagogastroduodenoscopy revealed a superficial elevated lesion with central depression approximately 20 mm in size in the posterior wall of the antrum of the stomach. Pathologic examination confirmed well-differentiated adenocarcinoma. The laboratory tests and tumor markers, including AFP, CA19-9, and CEA, were within the normal range. Computed tomography (CT) revealed the hepatic mass was approximately 33 mm in size in segment Ⅱ/Ⅲ of the liver. However, the imaging cannot reliably differentiate between sclerosing hemangioma and metastasis. He underwent a US-guided needle biopsy, but we couldn't obtain a biopsy specimen, as the firmness of the liver mass made it impossible to put the needle through into the core. Subsequently underwent a diagnostic laparoscopic wedge resection. The mass was histologically typical for a leiomyoma. Primary hepatic leiomyoma (PHL) is a very rare benign tumor, with only 36 cases reported in the world literature. Surgical resection is both diagnostic and curative. This is the first report describing PHL in the domestic literature and the first report describing PHL diagnosed with coexisting gastric cancer in the world literature. In conclusion, when the patient presents a hepatic mass with another malignancy, reliable tissue diagnosis is necessary to exclude this rare entity, especially if the imaging cannot reliably differentiate between hemangioma and metastasis.