Posterior reversible encephalopathy syndrome (PRES) in mesenteric leiomyosarcoma: A case report

Abstract

HighlightsPosterior reversible encephalopathy syndrome, syndrome characterized by headache, confusion, visual loss and seizures.Mesenteric leiomyosarcoma causing Posterior reversible encephalopathy syndrome.Symptoms disappearance after resection of the tumor, suggests a renin production cessation.

Primary Leiomyosarcoma of the Mesentery: A Case Report With Review of Literature

“…When mentioned, patients most commonly reported abdominal pain or palpable abdominal mass. Interestingly, one rare case presented with posterior reversible encephalopathy syndrome (PRES) [3]. The most commonly encountered location is the small intestine mesentery (seven cases), followed by the meso-sigmoid (five cases), ascending mesocolon (two cases), descending mesocolon (one case), mesorectum (one case), and 16% (three cases) only stated location as "mesenteric," without specification ( Although the size of the tumor was not always reported, the largest reported tumor was 230 mm [12], with a median size of 139 mm (range: 57-230 mm).…”

“…While the presentation of LMS is often vague and variable, it most commonly presents with obstructive symptoms such as nausea, vomiting, diarrhea, abdominal distention, and nonspecific abdominal pain. Many patients also have palpable abdominal masses and unintentional weight loss [3,4,9]. Approximately 50% of patients will develop distant metastasis, most commonly to the liver, and lungs [3,9,11], and rarely to adjacent lymph nodes [7]; therefore, routine lymph node dissection is not recommended.…”

“…The prognosis of LMS is quite poor as the overall five-year survival rate is at 20% to 30%, which is thought to be due to the large available space in the abdominal cavity, rendering the tumor undetectable until late in the disease course [3,4,9].…”

“…Hamed et al [11] n/a + n/a n/a + n/a n/a -Hamed et al [11] n/a + n/a n/a + n/a n/a -Dasgupta et al [18] n/a + n/a n/a + n/a n/a -Kato et al [5] n/a + n/a n/a + -n/a -Varghese et al [9] n/a + + n/a + n/a n/a n/a Ilias et al [6] n/a + + n/a + -+ -Dalal et al [1] n/a + n/a + + ---Schoucair et al [3] n/a + + n/a + n/a n/a n/a Yoon et al [14] n/a + n/a n/a + n/a n/a n/a Our reported case + + + + + -n/a n/a All patients were managed with surgical resection, apart from two cases where modality of treatment was not reported. The extent of resection was dependent on whether there is an invasion of adjacent structures.…”

“…Leiomyosarcoma (LMS) is a rare malignant soft tissue tumor that originates from smooth muscle cells, with an incidence rate of 1 per 350,000 cases [1,2]. Although mainly found in the retroperitoneum, uterus, and medium to large abdominal vessels, it can rarely arise from the mesenteric smooth muscles [3,4]. Prior to the development of immunohistochemical (IHC) staining, LMS was frequently misdiagnosed as a gastrointestinal stromal tumor (GIST), given the histological similarities as both entities are under the umbrella of gastrointestinal mesenchymal tumors.…”