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European J Pediatr Surg Rep. 2014; 02(01): 003-006
DOI: 10.1055/s-0034-1370773
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic-Assisted Endoscopic Resection of a Gastric Leiomyoma

Shannon Acker
1   Department of General Surgery, University of Colorado, Aurora, Colorado, United States
,
Megan Dishop
2   Department of Pediatric Pathology, University of Colorado, Aurora, Colorado, United States
,
Gregory Kobak
3   Department of Pediatric Gastroenterology, University of Colorado, Aurora, Colorado, United States
,
Padade Vue
3   Department of Pediatric Gastroenterology, University of Colorado, Aurora, Colorado, United States
,
Stig Somme
4   Department of Pediatric Surgery, University of Colorado, Aurora, Colorado, United States
› Author Affiliations
Further Information

Publication History

16 October 2013

03 January 2013

Publication Date:
12 March 2014 (online)

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Abstract

Leiomyomas are infrequent benign intestinal tumors that can arise at any age and location within the gastrointestinal (GI) tract. These tumors can cause symptoms including abdominal pain, obstruction, intussusception, volvulus, GI bleeding, or a mass and should be resected if symptomatic. Open surgical resection is considered the standard for removing these tumors. However, recent improvements in endoscopic and laparoscopic equipment have made it possible to utilize minimally invasive techniques of tumor removal including complete endoscopic resection or endoscopic-assisted laparoscopic resection. We present the case of an adolescent female with a large mass located at the gastroesophageal junction (GEJ) causing GI bleeding. Given the location of the mass near the GEJ and the morbidity associated with surgical resection, we performed laparoscopic-assisted complete endoscopic resection of tumor. In addition, this tumor had an unusual immunohistochemical-staining pattern, with focal expression of markers more often seen in GI stromal tumors, elucidating a gray area between these two tumor classes with potential implications for patient follow-up. Laparoscopic-assisted endoscopic resection of benign tumors is a useful technique that can be employed to facilitate resection of mucosal and subserosal masses near the GEJ with minimal morbidity.

Keywords

gastric leiomyoma - CD117 - endoscopy - DOG1