Duodenal leiomyosarcoma presenting with iron deficiency anemia

Area of Science:

• Pediatric Oncology
• Gastroenterology
• Hematology

Background:

• Iron deficiency anemia (IDA) is common in children and often linked to nutritional deficits or gastrointestinal (GI) blood loss.
• Persistent IDA despite iron supplementation warrants a thorough investigation into underlying causes, including malabsorption and occult bleeding.
• Leiomyosarcomas are rare mesenchymal tumors, with duodenal leiomyosarcoma being exceptionally uncommon in pediatric populations.

Observation:

• The authors present the third documented case of duodenal leiomyosarcoma in a child.
• The patient exhibited symptoms consistent with severe iron deficiency anemia.
• Standard endoscopic evaluation was inconclusive in identifying the source of blood loss or the tumor.

Findings:

• A diagnosis of duodenal leiomyosarcoma was established in a pediatric patient presenting with iron deficiency anemia.
• The tumor was successfully treated with wide surgical resection while preserving pancreatic function.
• This case underscores the importance of considering rare GI malignancies in the differential diagnosis of unexplained pediatric IDA.

Implications:

• Highlights the need for a broad differential diagnosis in pediatric iron deficiency anemia, including rare malignancies.
• Emphasizes the potential for duodenal leiomyosarcoma to present insidiously with anemia.
• Suggests that prompt surgical management can lead to favorable outcomes in pediatric duodenal leiomyosarcoma.