胃外型粘膜下腫瘍像を呈した悪性腹膜中皮腫の1例

Malignant peritoneal mesothelioma is a rare tumor. Its early detection and preoperativediagnosis is poor. We recently encountered a case of this tumor manifesting features similarto extragastric submucosal tumor. We describe this case, with a review of the literature.The patient was a 70-year-old woman. She was referred to our hospital because anelevated lesion in the stomach detected at another clinic during treatment of gastric ulcers.A mass, the size of a child’s head, was palpable, and extended from the left hypochondrialarea to the subumbilical area. Upper gastroenteric fluoroscopy, gastric endoscopy,ultrasonography, CT and abdominal angiography allowed a diagnosis of an extragastricsubmucosal tumor which had developed from the greater curvature of the stomach.Laparotomy was then performed. Jelly-like aggregates of ascites and a number of peritonealdisseminations were visible. The tumor was therefore removed by wedge resection ofthe stomach. Mitomycin C_ (10 mg) was sprinkled into the peritoneal cavity. Histopathologicalexamination of the removed tissue allowed a diagnosis of malignant peritoneal mesothelioma.It is known that malignant peritoneal mesothelioma may arise in various regions of theperitoneal cayity, however it is quite rare that this tumor is visible in the submucosal area ofthe stomach. This case therefore deserves to be reported.