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Perforated leiomyosarcoma of Meckel's diverticulum

J C Tan1, K S Wong, C H Teh

  • 1Division of General Surgery, Tan Tock Seng Hospital, Singapore.

Insights

Perforated Meckel's diverticulum leiomyosarcoma is rare but the most common tumor. This report details two unusual perforation cases, highlighting successful resection and disease-free outcomes in elderly patients.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Pathology

Background:

  • Meckel's diverticulum leiomyosarcoma is a rare malignancy.
  • It is the most common tumor arising from Meckel's diverticulum.
  • Clinical presentations typically include abdominal pain, bleeding, mass, or obstruction.

Observation:

  • Two cases of perforated Meckel's diverticulum leiomyosarcoma are presented.
  • Perforation is an uncommon presentation, occurring in only 4 of 59 reported cases.
  • Both patients presented with perforation, an unusual clinical manifestation.

Findings:

  • Despite late presentation with perforation, both tumors were resectable.
  • Neither patient had evidence of distant or local metastasis post-resection.
  • Both patients, aged 89 and 69, remained disease-free at 3 years and diagnosis respectively.

Implications:

  • Surgical resection is feasible even in advanced presentations of Meckel's diverticulum leiomyosarcoma.
  • Early diagnosis and prompt surgical intervention are crucial for favorable outcomes.
  • This highlights the importance of considering leiomyosarcoma in Meckel's diverticulum, even with atypical symptoms like perforation.

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