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Leiomyosarcoma mimicking acute appendicitis: a cautionary tale!

Louise Dunphy¹, Raluca Daniela Badea², Fawaz Musa²

¹Department of Surgery, The Royal Berkshire Hospital, Reading, UK Louise.Dunphy@doctors.org.uk.

BMJ Case Reports

|January 26, 2021

Summary

Appendiceal leiomyosarcoma is a rare mesenchymal tumor. This case highlights its occurrence in an immunocompromised individual, emphasizing the need for awareness in appendicitis presentations.

Keywords:

HIV / AIDS surgery

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Multimodality Diagnosis of Mesenteric Ischemia

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Published on: July 21, 2023

Area of Science:

Gastroenterology
Oncology
Pathology

Background:

Appendiceal neoplasms are rare, with carcinoid tumors and adenocarcinomas being most common.
Appendiceal leiomyosarcomas, a type of mesenchymal tumor, are exceptionally rare with limited reported cases.
The pathogenesis and genetic mechanisms of leiomyosarcomas remain incompletely understood.

Observation:

A 23-year-old female presented with acute appendicitis symptoms.
Laparoscopic appendectomy, converted to open surgery, revealed a leiomyosarcoma.
The patient had complications including a pelvic collection and ileus post-surgery.

Findings:

Histopathological examination confirmed appendiceal leiomyosarcoma.
The patient tested positive for HIV, indicating immune suppression.
Treatment involved anti-retroviral therapy, with surgical excision as the primary approach.

Implications:

This case underscores the importance of considering rare appendiceal tumors in immune-compromised patients presenting with appendicitis.
Early diagnosis and appropriate management are crucial for rare mesenchymal tumors.
Further research into the pathogenesis of appendiceal leiomyosarcomas in immunocompromised individuals is warranted.