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An infantile leiomyosarcoma that metastasized from the small intestine to the adrenal gland
Davut Sahin1, Handan Cetiner, Semih Mirapoglu
1Zeynep Kamil Maternal and Child Disease Educational and Research Hospital, Department of Pathology, Istanbul, Turkey. davutpato@gmail.com
Insights
This study reports a rare pediatric case of leiomyosarcoma originating in the small intestine and metastasizing to the adrenal glands. This highlights a unique presentation of pediatric soft tissue sarcoma.
Area of Science:
- Pediatric Oncology
- Gastrointestinal Pathology
- Adrenal Gland Tumors
Background:
- Leiomyosarcoma is a rare malignancy in children.
- Metastasis of small intestinal leiomyosarcoma to the adrenal glands is exceptionally uncommon in pediatric patients.
- Adrenal tumors in children often raise concerns for neuroblastoma or other primary adrenal malignancies.
Observation:
- A 10-year-old boy presented with chronic anemia, weight loss, and acute abdominal pain.
- Radiological imaging identified bilateral adrenal masses.
- Surgical resection of the terminal ileum and biopsy of an adrenal mass were performed.
Findings:
- Pathological examination confirmed leiomyosarcoma in both the small intestine and adrenal gland specimens.
- Immunohistochemical analysis supported the diagnosis and origin.
- This represents the first reported case of pediatric small intestinal leiomyosarcoma metastasizing to the adrenal glands.
Implications:
- This case expands the known metastatic patterns of pediatric leiomyosarcoma.
- It underscores the importance of comprehensive histopathological and immunohistochemical evaluation for pediatric adrenal masses.
- Further research into the behavior and treatment of rare pediatric gastrointestinal sarcomas is warranted.
Abstract:
In the literature, there is no reported pediatric leiomyosarcoma case that has metastasized from the small intestine to the adrenal gland. A 10-year-old boy who had anemia and weight loss over 2 years presented with abdominal pain that began 1 week previously. Radiologic examination revealed bilateral adrenal tumors. At the time of surgery, the terminal ileum was resected and a tru-cut biopsy was done from the right adrenal mass. The pathology report was leiomyosarcoma for both of the resection and tru-cut specimens. We present an intestinal leiomyosarcoma that metastasized from the small intestine to both adrenal glands with clinical, morphologic, and immunohistochemical studies with a literature review.
