Leiomyosarcoma of the Small Bowel Presenting with Intussusception: Case Report

Yıl 2021, Cilt: 2 Sayı: 1, 36 - 38, 25.04.2021

Merter Gülen Bahadır Ege

https://doi.org/10.51261/yiu.2021.00028

Öz

Introduction: Small bowel leiomyosarcoma is an extremely rare condition among gastrointestinal malignancies. They are often asymptomatic in the early stages and are difficult to diagnose by lower and upper gastrointestinal endoscopy. Case Report: A 30-year-old male patient with a diagnosis of hemophilia presented to us with complaints of abdominal pain, nausea and vomiting. Abdominal ultrasonography and computer tomography was done; a mass lesion, approximately 5×5 cm in size, causing invagination at the ileal level was observed. After preoperative preparations, the patient was operated on; laparotomy and the existing mass lesion was removed by segmenter small bowel resection and end-to-end anastomosis. He was discharged on the postoperative 3rd day without any complications. The patient, whose histopathologically presented leiomyosarcoma, was under oncological follow-up. Discussion: Small bowel leiomyosarcomas that differentiate from gastrointestinal stromal tumors can be distinguished by various immunohistochemical staining methods. Magnetic resonance enterography, computed tomography/colonography and capsule endoscopy may be needed in the differential diagnosis. Surgical resection still maintains its importance in the approach to such tumors, and the prognosis depends on tumor size and histological stage.

Anahtar Kelimeler

gastrointestinal stromal tumor, intestinal obstruction, leiomyosarcoma

İnce Barsakta İnvajinasyona Neden Olan Leiomyosarkom: Olgu Sunumu

Öz

Giriş: Gastrointestinal maligniteler arasında ince barsak leiomyosarkomu oldukça nadir görülen bir durumdur. Erken evrede sıklıkla asemptomatik olup alt ve üst gastrointestinal endoskopi ile oldukça zor tanı konulan patolojilerdir. Olgu Sunumu: Otuz yaşında hemofili-C tanısı olan erkek hasta karın ağrısı, bulantı ve kusma şikâyetleri nedeniyle tarafımıza başvurdu. Yapılan tetkiklerde ileal düzeyde invajinasyona neden olan yaklaşık 5×5 cm boyutlarında kitle lezyon izlendi. Preoperatif hazırlıklar sonrası hastaya laparatomi yapılarak mevcut kitle lezyon segmenter ince barsak rezeksiyonu, uç-uca anastomoz yapılarak çıkarıldı. Postoperatif 3. gün sorunsuz taburcu edildi. Histopatolojik olarak leiomyosarkom gelen hasta onkolojik takibe alındı. Tartışma: Gastrointestinal stromal tümörlerden differansiyasyon gösteren ve çeşitli immünohistokimyasal boyama yöntemleri ile ayırt edilebilen ince barsak leiomyosarkomları oldukça nadir karşılaşılan bir durumdur. Ayırıcı tanıda manyetik rezonans enterografi, bilgisayarlı tomografi/kolonografi ve kapsül endoskopi gibi yöntemlere ihtiyaç duyulabilmektedir. Bu tür tümörlere yaklaşımda halen cerrahi rezeksiyon önemini korumakta olup prognoz tümör boyutu ve histolojik evresine bağlıdır.

Anahtar Kelimeler

gastrointestinal stromal tümör, intestinal obstrüksiyon, leiomyosarkom

Kaynakça

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