Superior mesenteric arterial occlusion from a leiomyoma

We report a solitary leiomyoma of the superior mesenteric artery resulting in arterial occlusion and gangrenous bowel. On histologic evaluation the lesion extended into the vessel lumen off its stalk and showed immunostaining for smooth muscle antigen and desmin. Leiomyomas can arise anywhere there is smooth muscle and occur most commonly in the uterus followed by the skin and gastrointestinal tract. We could not identify any previous case in the literature of a leiomyoma arising from within the wall of a mesenteric vessel.