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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2003 February;16(1):25-8
Leiomyosarcoma of the small intestine. A case report
Interlandi A., Busacca G.
Malignant tumours of the small intestine are rare, representing as they do 1-3% of all malignant neoplasias of the digestive tube. Leiomyosarcomas consistute 9-11% of cases. The symptomatology is vague, aspecific and non-pathognomonic. This explains the reason why recognition of these conditions can be tardy. Manifestations are often related to the onset of a complication, represented most frequently by occlusion followed, in decreasing order, by digestive haemorrhage and by perforation. Diagnosis, reached by radiology and at times by endoscopy, is unreliable, ineffective and often unspecific. Help is available today from the use of the videopill. Diagnosis of small intestine cancer, as can be seen in the literature, is often intraoperative and this is seen in cases in which the patient is submitted to emergency (in the presence of an acute complication) or elective (in the absence of a clear diagnosis) surgery. Metastases are present with some frequency at the time of diagnosis. Post-surgical survival at 5 years is 50%. Surgical therapy is resective, possibly ample. Complementary treatments (particularly polychemotherapy) are not yet able to modify survival. The authors report a case of leiomyosarcoma of the preterminal small intestine. The patient was female and presented vague, aspecific symptoms. She came to the operating table with a diagnosis of lower right abdominal mass. Diagnosis was intraoperative. We performed a sweeping resection with removal of the corresponding mesenter. One year after operation, the patient is alive and asymptomatic. The case we report is in line with other reported cases.