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Gastric Smooth Muscle, Nerve Sheath, and Related Tumors

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Pathology of the Stomach and Duodenum

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Abstract

Small gastric smooth muscle tumors are common in adults at autopsy. Meissner in 19441 observed them in almost 50% of such cases by careful manual examination of the stomach wall. More recently, microleiomyomas of 5 mm or less diameter were detected in 16.4% of resected stomachs, mostly in the upper half.2 Thus, the larger leiomyomatous tumors of the stomach must, in current parlance, be suspected of possessing increased receptor activity for certain undefined growth factors. Platelet- xderived growth factor (PDGF), a smooth muscle growth stimulant, might be involved.3 Estrogens, of course, stimulate uterine leiomyoma growth, which ceases in their absence, but estrogens do not appear to affect similar gastric tumors that are equally common in men and women. Clinically, gastric smooth muscle tumors, benign or malignant, are asymptomatic when small unless they ulcerate and bleed. Larger solid intramural stomach tumors are spheroidal and may bulge into the lumen, stretch the serosa, or both. The classic radiologic and endoscopic appearance of gastric leiomyoma or leiomyosarcoma is a protrusive hemispherical mass in the fundus or body of the stomach, which stretches the mucosa and has an apical central volcano-like cratered ulcer that bleeds.

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Authors and Affiliations

  1. Department of Pathology, University Hospital, New York University Medical Center, 10016, New York, NY, USA

    Heidrun Rotterdam M.D. (Associate Professor of Surgical Pathology, Attending Pathologist)

  2. Hospital of the University of Pennsylvania Medical School, 19104, Philadelphia, PA, USA

    Horatio T. Enterline M.D. (Professor Emeritus of Surgical Pathology)

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  1. Heidrun Rotterdam M.D.
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  2. Horatio T. Enterline M.D.
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Rotterdam, H., Enterline, H.T. (1989). Gastric Smooth Muscle, Nerve Sheath, and Related Tumors. In: Pathology of the Stomach and Duodenum. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3550-7_11

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  • DOI: https://doi.org/10.1007/978-1-4612-3550-7_11

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