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Abscessed leiomyosarcoma of the ileum
1Department of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Japan.
Summary
A rare case of ileal leiomyosarcoma presented as a lower abdominal mass with fever and pain. Surgical removal confirmed the diagnosis, highlighting the importance of comprehensive imaging in diagnosing such gastrointestinal tumors.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Imaging
Background:
- Leiomyosarcomas are rare soft tissue sarcomas that can occur anywhere in the gastrointestinal tract.
- Ileal leiomyosarcomas are particularly uncommon and can present with vague or nonspecific symptoms.
Observation:
- A 49-year-old male presented with a five-day history of fever and lower abdominal pain, along with a palpable suprapubic mass.
- Initial imaging revealed a large pelvic gas collection, mimicking an abscess, prompting further investigation.
Findings:
- Advanced imaging, including CT and MRI, identified a large, saccular mass arising from the ileum, measuring 11 x 6 x 5 cm.
- The tumor contained a significant amount of pus, suggesting secondary infection or necrosis.
- Pathological examination confirmed the diagnosis of leiomyosarcoma of the ileum.
Implications:
- This case underscores the diagnostic challenge posed by ileal leiomyosarcomas, which can mimic other intra-abdominal pathologies.
- Comprehensive imaging and histopathological analysis are crucial for accurate diagnosis and effective management of these rare tumors.
- Surgical resection remains the primary treatment modality for localized ileal leiomyosarcomas.