Small bowel liposarcoma--a rare cause of small bowel perforation

A 76-year-old patient was admitted with right-sided lower abdominal pain. CT scan of the abdomen demonstrated a fatty mass arising around the bowel in the left iliac fossa causing local distortion of the vasculature. His clinical condition rapidly deteriorated with worsening abdominal signs necessitating an exploratory laparotomy. A segment of perforated small bowel associated with mesenteric mass was excised and the patient died 3 days later. The histology demonstrated a well-differentiated liposarcoma. Liposarcomas are the most common soft tissue sarcomas in adults but occurrence in the gastrointestinal tract is extremely rare. The clinical presentation of these tumours is frequently non-specific and commonest symptoms are generalised, intermittent abdominal pain. Surgical resection with clear margins is the treatment of choice for primary liposarcomas. They are moderately radiosensitive and chemotherapy is non-effective. Although gastrointestinal liposarcomas have been previously reported, this is the first reported case of a primary liposarcoma associated with a small bowel perforation.