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Colorectal leiomyosarcomas: a pathobiologic study with long-term follow-up
R Friesen1, T N Moyana, R B Murray
1Department of Surgery, University of Saskatchewan, Royal University Hospital, Saskatoon.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|October 1, 1992
Summary
Colorectal leiomyosarcoma (CLM) is a rare cancer. This study of 12 cases highlights its low incidence, common symptoms like bleeding, and poor diagnostic accuracy, recommending wide surgical excision for suspected malignancy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Colorectal leiomyosarcoma (CLM) is a rare gastrointestinal malignancy.
- Published data primarily consists of case reports and small series.
- Understanding CLM epidemiology and clinical behavior is limited.
Purpose of the Study:
- To document the incidence and characteristics of colorectal leiomyosarcoma.
- To evaluate diagnostic accuracy and treatment outcomes for CLM.
- To provide recommendations for the management of CLM.
Main Methods:
- Retrospective review of 12 colorectal leiomyosarcoma cases over 28 years.
- Analysis of incidence, tumor location, presenting symptoms, diagnostic methods, and treatment.
- Evaluation of patient follow-up data for recurrence and metastasis.
Main Results:
- Annual CLM incidence was 0.45 per million; 0.12% of all colorectal malignancies.
- CLM predominantly affected the rectum and sigmoid, presenting with rectal bleeding or abdominal pain.
- Histologic diagnosis was accurate preoperatively in only 2 of 6 cases.
- 10 patients underwent surgery; 8 experienced recurrence or metastasis after a mean follow-up of 6.9 years.
Conclusions:
- Colorectal leiomyosarcoma is rare with a significant rate of recurrence and metastasis.
- Diagnostic challenges exist, with limited preoperative accuracy.
- Wide surgical excision is recommended for suspected colorectal smooth muscle tumors.