[Duodenal leiomyosarcoma revealed by gastrointestinal hemorrhage]

Leiomyosarcomas account for approximately 75% of all gastrointestinal sarcomas but only 8-10% of duodenal malignancies. Pain and bleeding are the principal symptoms. Prognosis of these tumors is difficult to assess. If excision is successful, however, prognosis is usually good. We report the case of a patient with leiomyosarcoma of the duodenum first identified because of gastrointestinal hemorrhage.

We report the case of a 57-year-old women who underwent duodenopancreatectomy for duodenal leiomyosarcoma. Histological and immunohistochemical findings confirmed the diagnosis of low-grade leiomyosarcoma and ruled out a gastrointestinal stromal tumor.

Duodenal leiomyosarcomas are very rare. Preoperative diagnosis is difficult. The combination of a mass and a hemorrhage must suggest the presence of leiomyosarcoma. Radiological and endoscopic findings may not be conclusive: only histologic examination provided the definitive diagnosis here. Many criteria have been used to assess prognosis; complete resection appears to be the principal prognostic factor and is associated with improved survival.