近四十年来,国内外有关胃肠平滑肌肿瘤报告已达数千例,但多数均为中晚期。本例先后发生十二指肠平滑肌肉瘤及继发性肝平滑肌肉瘤,均为直径不超过4cm的“小肉瘤”。兹报告如下: 胡××,男性,50岁,江苏丹阳人,住院号175240。患者十年前因胃小弯溃疡行毕罗氏二式胃次全切除术,近五年间歇出现柏油样大便,多次内窥镜检查提示“吻合口炎伴出血,返流性胃炎”,于1982年2月行“吻合口切除、残胃-空肠Roux-y吻合及迷走神经切断术”。术后二个余月又出现黑便,内窥镜及钡餐检查均未见上消化道新生物,但体检发现右中腹部乒乓球大小肿物,表面光滑、无压痛、移动度大。同年5月再次手术,发现十二指肠水平部肿瘤,灰白夹暗红色,质软,基底宽,3×3×3cm。术中行瘤段十二指肠楔形切除术。病理报告为十二指肠平 In the past 40 years, thousands of cases of gastrointestinal smooth muscle tumors have been reported at home and abroad, but most of them are in the middle and late stages. In this case, duodenal leiomyosarcoma and secondary hepatic leiomyosarcoma have occurred successively, all of which are small sarcomas with a diameter of no more than 4cm. The report is as follows: Hu X, male, 50 years old, Danyang, Jiangsu Province, hospital number 175240. The patient underwent Birol’s second subtotal gastrectomy for minor gastric ulcer ten years ago. There was intermittent tarry stool in the past five years. Multiple endoscopic examinations suggested that “anastomotic inflammation with bleeding, reflux gastritis”. In February 1982, “anastomotic resection, residual gas-jejunum Roux-y anastomosis and vagotomy were performed.” In the second month after the operation, black stools appeared again. No endoscopy or barium meal examination revealed new gastrointestinal neoplasms. However, the physical examination revealed that the right mid-abdomen ping-pong size tumor had a smooth surface, no tenderness, and large mobility. In May of the same year, the operation was performed again. Tumors at the level of the duodenum were found. The gray-white clip was dark red, soft, and the base was wide, 3 x 3 x 3 cm. Intraoperative tumor segment duodenal wedge resection. Pathology report duodenal flat