Mesenteric Lymph Node Recurrence of a Primary Colorectal Leiomyosarcoma.
Amélie Beauchamp1,2, Roy Hajjar1,2, Sharmila Khullar3
1Department of Surgery, Université de Montréal, Montreal, Canada.
Case Reports in Surgery
|April 8, 2020
Summary
Primary colorectal leiomyosarcoma is rare and aggressive. This case highlights a rare mesenteric lymph node metastasis 14 months post-surgery, raising questions about managing such recurrences.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Primary colorectal leiomyosarcoma is an exceptionally rare malignancy.
- This tumor type exhibits aggressive behavior and a propensity for hematogenous metastasis.
- Current treatment guidelines emphasize surgical resection as the primary intervention.
Observation:
- A 49-year-old patient presented with a two-month history of fever.
- Positron Emission Tomography-scan (PET-scan) identified a hypermetabolic transverse colon mass, confirmed as leiomyosarcoma via colonoscopy and hemicolectomy.
- Fourteen months post-operatively, a follow-up scan revealed a hypermetabolic mesenteric lymph node, diagnosed as leiomyosarcoma metastasis upon resection.
Findings:
- The case documents a late recurrence of colorectal leiomyosarcoma as a mesenteric lymph node metastasis.
- Histopathological confirmation of leiomyosarcoma in both the primary tumor and the metastatic lymph node.
Implications:
- This case introduces controversy regarding the optimal management of rare lymph node recurrences in colorectal leiomyosarcoma.
- It underscores the need for further investigation into surveillance strategies and treatment protocols for advanced or recurrent colorectal leiomyosarcoma.
- Highlights the importance of considering leiomyosarcoma metastasis in the differential diagnosis of hypermetabolic mesenteric lymphadenopathy in patients with a history of colorectal cancer.
