Two cases of primary leiomyosarcoma of sigmoid colon treated with laparoscopic surgery: A case report and a review of literature

Bananzadeh, Alimohammad; Mokhtari, Maral; Sohooli, Maryam; Shekouhi, Ramin

doi:10.1016/j.ijscr.2021.106420

Cited by 9 publications

(9 citation statements)

References 32 publications

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“…Based on a search of the main online databases (Embase, PubMed, MEDLINE, and Google Scholar), 37 cases of colonic LMS have been published. Among them, liver metastases were found in eight patients, and two patients were referred for resection for liver metastases, all of which were synchronous metastases[ 5 , 6 ]. One patient was a 74-year-old woman who was diagnosed with a descending colon cancer with liver metastasis in segment 5/6 of the liver.…”

Section: Discussionmentioning

confidence: 99%

Curative resection of leiomyosarcoma of the descending colon with metachronous liver metastasis: A case report

Lee¹,

Bae²,

Lee³

et al. 2023

World J Gastrointest Surg

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BACKGROUND Leiomyosarcoma (LMS) has a poor prognosis and rarely originates from the colon. If resection is possible, surgery is the first treatment most commonly considered. Unfortunately, no standard treatment exists for hepatic metastasis of LMS; although, several treatments, such as chemotherapy, radiotherapy, and surgery, have been used. Subsequently, the management of liver metastases remains controversial. CASE SUMMARY We present a rare case of metachronous liver metastasis in a patient with LMS originating from the descending colon. A 38-year-old man initially reported abdominal pain and diarrhea over the previous two months. Colonoscopy revealed a 4-cm diameter mass in the descending colon, 40 cm from the anal verge. Computed tomography revealed intussusception of the descending colon due to the 4-cm mass. The patient underwent a left hemicolectomy. Immunohistochemical analysis of the tumor revealed that it was positive for smooth muscle actin and desmin, and negative for cluster of differentiation 34 (CD34), CD117, and discovered on gastrointestinal stromal tumor (GIST)-1, which are characteristic of gastrointestinal LMS. A single liver metastasis developed 11 mo post-operatively; the patient subsequently underwent curative resection thereof. The patient remained disease-free after six cycles of adjuvant chemotherapy (doxorubicin and ifosfamide), and 40 and 52 mo after liver resection and primary surgery, respectively. Similar cases were obtained from a search of Embase, PubMed, MEDLINE, and Google Scholar. CONCLUSION Early diagnosis and surgical resection may be the only potential curative options for liver metastasis of gastrointestinal LMS.

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Section: Discussionmentioning

confidence: 99%

Curative resection of leiomyosarcoma of the descending colon with metachronous liver metastasis: A case report

Lee¹,

Bae²,

Lee³

et al. 2023

World J Gastrointest Surg

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“…LMS of the GI tract is extremely rare with an incidence compared to gastrointestinal stromal tumor (GIST) of 1:50-65 [1,5,6]. Its biological behavior is aggressive, and it has a poor prognosis; the response rates of chemotherapy and targeted treatments such as the administration of tyrosine kinase inhibitors, on LMS have been low [7,8], and radiotherapy also seems to be unbeneficial due to radio-resistance [9,10]. Thus, surgical resection has remained the only curative treatment option.…”

Section: Discussionmentioning

confidence: 99%

“…Although the number of reports on the LMS of the GI tract has been limited, the number of reports of minimal invasive surgery for the LMS of the GI tract have been recently increasing with favorable outcomes. A PubMed search using the key words "leiomyosarcoma" and "laparoscopic surgery" since 1998 revealed six case reports (seven patients) of laparoscopic resection of the LMS in the GI tract [6,9,11,[15][16][17]. Among them, two cases were located in the small intestine, one in the stomach, and the remaining four in the colon.…”

Section: Discussionmentioning

confidence: 99%

Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report

et al. 2022

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Background A leiomyosarcoma of the gastrointestinal tract is extremely rare. We report a case of jejunal leiomyosarcoma with intestinal intussusception at the angle of Treitz that was successfully treated with laparoscopic resection followed by intracorporeal reconstruction using a delta-shaped anastomosis. Case presentation A 54-year-old man was referred to our hospital due to fatigue and loss of appetite. Blood tests showed anemia. Enteroscopy and subsequent enterography using meglumine sodium amidotrizoate showed easily hemorrhagic tumor (10 cm in diameter) in the jejunum just beyond the angle of Treitz. Contrast-enhanced computed tomography revealed jejunojejunal intussusception. Histopathological examination of a biopsy specimen revealed a leiomyosarcoma. Laparoscopic resection of the tumor without reduction of the intussusception was performed. The resected line of the proximal intestine was very close to the ligament of Treitz in the present case. Intracorporeal jejunojejunostomy was completed using a delta-shaped anastomosis, wherein anastomosis was performed between the posterior walls of the proximal and distal jejunums after minimal mobilization around the ligament of Treitz. The patient’s postoperative course was uneventful, and he was discharged at 10 days postoperatively. No recurrence has been observed within 2 years after surgery. Conclusions We present a case in which a totally laparoscopic surgery for leiomyosarcoma located at the angle of Treitz with jejunojejunal intussusception was performed successfully.

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“…13 In most cases, pcLMS is localized in the sigmoid colon, followed by the ascending colon. 6 Because of nonspecific clinical symptoms and diagnostic signs, an interdisciplinary collaboration between gastroenterologists, radiologists, pathologists, and surgeons is crucial for diagnosing pcLMS in early disease stages. Unclear histological findings of smooth muscle cell tissue in colonic biopsies and a tumor of the colon wall on CT imaging should lead to the differential diagnosis of pcLMS and further diagnostics.…”

Section: Outcome and Follow-upmentioning

confidence: 99%

Diagnostic and therapy of an early‐stage primary leiomyosarcoma of the sigmoid colon: A case report

Fickenscher,

Gvozdenovic,

Ponsel

2024

Clinical Case Reports

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Key Clinical MessagePrimary leiomyosarcoma of the colon is a very rare tumor entity. Because of unspecific findings, diagnostic can be challenging. Most cases are diagnosed in advanced stages with poor overall survival. Unclear histological findings of smooth muscle cell tissue in colon biopsies together with a tumor of the colon wall in computed tomography (CT) imaging should lead to the differential diagnosis of primary colonic leiomyosarcoma and further diagnostic procedures.AbstractPrimary colonic leiomyosarcoma is an extremely rare tumor entity arising from smooth muscle cells in the colon wall. Only 0.1% of all colorectal malignancies are leiomyosarcomas. Most patients are diagnosed in advanced disease stages. The overall survival rates are low, and recurrence rates are high. Only few data regarding the outcome in localized early disease stages are available. We report the case of an early‐stage primary leiomyosarcoma of the sigmoid colon treated with surgical resection. We present the case of a 53‐year‐old male patient who underwent a colonoscopy due to intermittent rectal bleeding. Colonoscopy revealed an intraluminal polypoid growing tumor in the sigmoid colon. A biopsy was performed with inconclusive histological results. A CT scan revealed a process in the sigmoid colon with wall thickening; there was no evidence of metastatic lesions. After laparoscopic oncological resection of the sigmoid colon, histological examination surprisingly revealed a localized high‐grade leiomyosarcoma. Primary leiomyosarcoma of the colon is a rare tumor entity and diagnostic can be challenging. Only a few patients with colonic leiomyosarcoma diagnosed in localized early disease stages and treated with complete surgical resection have been reported in the literature. These patients seem to have a better prognosis with longer overall survival. Because of unspecific diagnostic findings and the lack of symptoms in early disease stages, interdisciplinary collaborations between gastroenterologists, radiologists, pathologists, and surgeons are crucial for early diagnosis and treatment.

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Two cases of primary leiomyosarcoma of sigmoid colon treated with laparoscopic surgery: A case report and a review of literature

Cited by 9 publications

References 32 publications

Curative resection of leiomyosarcoma of the descending colon with metachronous liver metastasis: A case report

Curative resection of leiomyosarcoma of the descending colon with metachronous liver metastasis: A case report

Totally laparoscopic resection using delta-shaped anastomosis of jejunal leiomyosarcoma with intussusception at the angle of Treitz: a case report

Diagnostic and therapy of an early‐stage primary leiomyosarcoma of the sigmoid colon: A case report

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