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A. Distended abdomen before surgery. B. Computed tomography revealed the large cyst and solid component showing enhancement. C, D. T2-weighted magnetic resonance imaging also showed the large cyst and solid component with high signal intensity.
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A 56-year-old man was referred to our hospital with a 6-month history of abdominal distension and discomfort (Fig. 1A). It included a large cyst and solid component that showed enhancement (Fig. 1B). The solid component showed high signal intensity on T2-weighted imaging and diffusion-weighted imaging (Fig. 1C, D).
A. We gradually dissected along the capsule of the caudal side of the tumor, and most of the tumor was able to be moved outside the body. B. The resected specimen weighed 13,000 g and measured 38 x 20 x 19 cm. Part of the stomach wall seemed to be pulled by the tumor (arrow). C. The cyst was opened and examined from the inside. D. No abnormalities were found on the intraluminal surface of the stomach and transverse colon wall. (1) Indicates the arrow portion of picture B.
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We gradually dissected along the capsule and moved the tumor outside the body (Fig. 2A). Macroscopic examination revealed a 38- x 20- x 19-cm tumor weighing 13,000 g (Fig. 2B).
A. Cut surface of (1). The solid component of the tumor showed continuity with the stomach wall. B. Tumor cells developed from the submucosa of the stomach and grew extraluminally. C, D. The tumor was composed mainly of short spindle and vacuolated cells, including lipoblasts and mature adipocytes, with a myxomatous matrix.
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The main mass was located in the abdominal cavity, but the tumor base was broadly adhered to the gastric wall and seemingly grew from the gastric submucosa, suggesting that the tumor had likely arisen from the stomach (Fig. 3).