Obstructive Small Bowel Metastasis from Uterine Leiomyosarcoma: A Case Report

Abstract

Background. Uterine leiomyosarcoma is a rare and aggressive gynecologic malignancy with an overall poor prognosis. Lungs, bones, and brain are common sites of metastases of uterine leiomyosarcoma. Metastases of uterine leiomyosarcoma to the small bowel are extremely rare, and only four case reports have been published to date. Case presentation. A 55-year-old Saudi woman diagnosed with a case of uterine leiomyosarcoma treated with total abdominal hysterectomy (TAH) and bilateral salpingooophorectomy (BSO) presented in emergency room after sixteen months with acute abdomen. Subsequent work-up showed a jejunal mass for which resection and end-to-end anastomosis were performed. Biopsy confirmed the diagnosis of small bowel metastasis from uterine leiomyosarcoma. Further staging work-up showed wide spread metastasis in lungs and brain. After palliative cranial irradiation, systemic chemotherapy based on single agent doxorubicin was started. Conclusion. Metastatic leiomyosarcoma of small bowel from uterine leiomyosarcoma is a rare entity and is sign of advanced disease. It should be differentiated from primary leiomyosarcoma of small bowel as both are treated with different systemic chemotherapeutic agents.

MMPs and angiogenesis affect the metastatic potential of a human vulvar leiomyosarcoma cell line

“…The propensity of SK‐LMS‐1 cells to spread to distal portions of the CAM mesenchyme as well as to the embryo liver is consistent with the high propensity of vLMS to infiltrate secondary organs .…”

“…In our experimental condition, SK-LMS-1 cells might enable their own growth and spreading by both expressing pro-angiogenic factors and modulating the expression of chick angiogenic factors. The propensity of SK-LMS-1 cells to spread to distal portions of the CAM mesenchyme as well as to the embryo liver is consistent with the high propensity of vLMS to infiltrate secondary organs [4][5][6][7][8][9][10].…”

“…Gynaecological leiomyosarcomas (gLMS) represent a heterogeneous group of soft tissue sarcoma [1][2][3] of mesenchymal origin [1], that although have a rare incidence, present high aggressiveness, and propensity to infiltrate secondary organs [4][5][6][7][8][9][10], poor prognosis and lethality because of the lack of effective treatments [11,12].…”

Metastatic Uterine Leiomyosarcoma presenting as small bowel intussusception at two independent visits

“…The lungs are the most common site of metastasis, followed by the pelvis, liver, bone, and brain. In a review of the literature, only three other small bowel metastases from uLMS have been reported ( Ben-Ishay et al, 2010 , Saylam et al, 2009 , Tunio et al, 2014 ). Our patient had several metastatic lesions to her small bowel, liver, lung, and brain during the course of her disease.…”

Skull Metastasis From Uterine Leiomyosarcoma, a Rare Presentation for a Rare Tumor: A Case Report and Review of the Literature

“…Lung, liver, peritoneal cavity, pelvic lymph nodes, vertebral and long bones are typically reported sites of recurrent uLMS (7). The array of tools currently available in imaging techniques and the prompt detection in high-risk patients has allowed the identification of more atypical patterns of uLMS recurrence, such as heart, parotid gland, gastrointestinal tract, brain, and skull (8)(9)(10).…”