Jejunal leiomyosarcoma leading to intestinal intussusception: a case report

Leiomyosarcoma (LMS) is a rare form of malignant tumor affecting the small intestine, specifically the jejunum. It can cause intussusception, a condition wherein one segment of the intestine telescopes into another, leading to obstruction, ischemia, and necrosis. Small intestinal intussusception in adults is a rare clinical condition. The majority of affected individuals have pathological factors, such as tumors, polyps, diverticula, inflammation, or intestinal adhesions. Abdominal pain and bowel obstruction are the most common symptoms, but small bowel tumors are often not visible on endoscopy, making additional imaging essential for accurate diagnosis. Herein, we report the clinical presentation, diagnosis, and treatment of jejunal LMS-induced intussusception in an adult patient.

A 56-year-old female was first admitted to our hospital in June 2024 due to intermittent abdominal distension and pain with paroxysmal exacerbation, and her abdominal pain lasted for more than 10 days. There was no hematemesis or melena. Initial computed tomography (CT) scans showed no abnormalities, but subsequent imaging revealed a left mid-abdominal jejuno-jejunal intussusception. The histopathological and immunostaining findings indicated jejunal LMS without metastasis, and emergency laparotomy revealed an intestinal tumor at the intussusception site. The tumor was surgically resected, and postoperative follow-up is underway. To date, the patient remains well but has declined further recommended testing and therapy.

This case underscores the uncommon clinical presentation of LMS-induced intestinal intussusception in adults. Timely diagnosis and intervention are critical for improving survival outcomes in patients with LMS. Surgical resection remains the treatment of choice for eligible candidates.