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Superior mesenteric arterial occlusion from a leiomyoma
S Levin1, E Catalano, J B Alexander
1Department of Surgery, The Cooper Health System, Robert Wood Johnson Medical School, Camden, NJ, USA.
Journal of Vascular Surgery
|April 18, 1998
Summary
A rare solitary leiomyoma in the superior mesenteric artery caused arterial occlusion and gangrenous bowel. This smooth muscle tumor, identified via immunostaining, is the first documented case within a mesenteric vessel wall.
Area of Science:
- Vascular Surgery
- Gastrointestinal Pathology
- Surgical Oncology
Background:
- Leiomyomas are benign smooth muscle tumors, commonly found in the uterus, skin, and gastrointestinal tract.
- Vascular leiomyomas are rare, with most documented cases occurring in peripheral vessels.
- Mesenteric artery tumors are uncommon, often presenting with non-specific symptoms.
Observation:
- A solitary leiomyoma was identified originating from the superior mesenteric artery.
- The tumor extended into the arterial lumen, causing significant obstruction.
- Histologic examination confirmed smooth muscle origin with positive immunostaining for smooth muscle actin and desmin.
Findings:
- The leiomyoma led to superior mesenteric artery occlusion, resulting in bowel ischemia and gangrene.
- This represents the first reported instance of a leiomyoma arising within the wall of a mesenteric artery.
- The tumor's intraluminal extension was a critical factor in the arterial occlusion.
Implications:
- Highlights the potential for leiomyomas to occur in unusual locations, including major visceral arteries.
- Emphasizes the importance of considering rare vascular tumors in the differential diagnosis of mesenteric ischemia.
- Suggests the need for vigilance in evaluating mesenteric masses, even when typical leiomyoma locations are not involved.