A CASE OF LEIOMYOSARCOMA OF THE ILEUM

Abstract

We report a case of leiomyosarcoma of the ileum that is rare in tumors of the gastrointestinal tract. A 70-year-old man was admitted to the faculty because of tumor in the right lower abdomen. On barium study of the small intestine, a narrowing of the lumen and leak of barium out of the lumen were detected in the ileum. Abdominal ultrasonography visualized a well defined mass that was heterogenous in the internal echo. Abdominal CT showed an enhanced tumor measuring 8×9cm, in which the cystic formation was seen with air density area. Angiographically there was a tumor stain feeded from the ileal branch. Leiomyosarcoma was strongly suspected preoperatively, and a partial resection of the ileum including the tumor was carried out. In resected specimen, the extraluminally grown tumor and the ulcer were recognized in 80cm oral from the ileocecal valve. The portion that appeared to be a cyst on CT was proven to be necrotized abscess cavity and be passed to the ulcer. Histopathological diagnosis was made as leiomyosarcoma because mild nuclear atypism, two mitotic figures in ×400 field, the tumor more than 5cm in diameter, central necrosis, and ulcer formation were confirmed.