GASTRIC STROMAL TUMOR WITH PERITONEAL NODULES IN PREGNANCY - TUMOR SPREAD OR RARE VARIANT OF DIFFUSE LEIOMYOMATOSIS

Gastric tumors discovered during pregnancy are rare. A cystic gastric stromal tumor with adjacent peritoneal nodules and associated with asc ites was encountered in a 32-year-old pregnant patient. On initial cli nical evaluation the mass was thought to originate from the uterine ad nexa. The tumor itself was composed of uniform spindle cells with mini mal mitotic activity. Immunohistochemical and ultrastructural studies were consistent with a gastrointestinal stromal tumor (GIST). Small no dules on the gastric serosa and adjacent omentum resembled those of le iomyomatosis peritonealis disseminata but were confined to the upper a bdomen and on further study lacked evidence of smooth muscle different iation. Although many of these nodules were not resected, a CT scans 3 and 9 months later failed to detect them. This case of GIST in pregna ncy is apparently unique and distinct from leiomyomatosis peritonealis disseminata and rare forms of intestinal leiomyomatosis. (C) 1996 Aca demic Press, Inc.