Abstract
Leiomyosarcoma is a rare malignancy of smooth muscle. Leiomyosarcoma may arise from the retroperitoneum and present with nonspecific signs and symptoms. The most common presentation is abdominal pain. In the past gastrointestinal stromal tumour (GIST) were misdiagnosed as leiomyosarcoma. GISTs however have been shown to lack features of smooth muscle tumors on histopathology. They are often CD34 and CD 117 immunoreactive in contrast to leiomyosarcoma. We present a rare case of retroperitoneal leiomyosarcoma with gastrointestinal stromal tumour of rectum in the same patient.
Highlights
A 45 year man presented to Surgery opd with chief complaints of rectal bleeding and constipation for 1 month
There was a history of histopathological and immunohistochemistry proven retroperitoneal leiomyosarcoma (Figure 1) for which he was operated in tertiary center 8 months back
CT abdomen was planned and revealed an ill defined lobulated soft tissue lesion of size 10 ́12 ́8 cm seen within pelvis encasing sigmoid colon, left ureter causing hydroureteronephrosis
Summary
A 45 year man presented to Surgery opd with chief complaints of rectal bleeding and constipation for 1 month. There was a history of histopathological and immunohistochemistry proven retroperitoneal leiomyosarcoma (Figure 1) for which he was operated in tertiary center 8 months back. Colostomy was done and was closed after 3 months He received 2 cycles of gemcitabine and docetaxel based chemotherapy. His physical exam was unremarkable other than a digital rectal exam which revealed a firm mass in the posterior rectal wall. Histopathology revealed differential diagnosis for leiomyosarcoma and gastrointestinal stromal tumour (GIST). Ultrasound abdomen showed a heterogenous ill defined mass lesion in the retroperitoneum region with left side hydroureteronephrosis with mesenteric lymphadenopathy. The features suggestive of recurrent leiomyosarcoma with left side hydroureteronephrosis. He is presently on imatinib based chemotherapy and doing well with no complication
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