Cover Image

Leiomyosarcoma of Colon Presented as Retroperitoneal Mass: A Rare Case Report

Vijay Kumar, Ashok Kumar, Gyan Chand, Goonj Johri

Abstract


Introduction: Retroperitoneal tumors are lesions with diverse pathological subtypes that originate from the retroperitoneal space. About forty percent of these tumors are benign. These lesions are often surrounded and associated with vital abdominal blood vessels; therefore, a complete surgical resection is difficult.

Presentation of the case: Here we are presenting a 42-year-old female presented with abdominal lump from last two monthswith persistent abdominal pain from one month. The computed tomography and ultrasound scan confirmed the presence of a solid retroperitoneal tumor. She underwent surgical exploration and histology confirmed that the tumor composed of spindle shaped cells disposed in intersecting fascicles, whirling and storiform pattern. The tumor cells are oval to spindle shaped with blunt ended nuclei, dispersed chromatin and moderate amount of cytoplasm. On immunohistochemical staining, tumor cells were positive for vimentin. The patient was followed up for two years, with no evidence of tumor recurrence. No standardized guidelines have been established for its treatment because too small a number of cases have been reported, but surgical resection was considered the treatment of choice. In summary, we report a unique case who developed leiomyosarcoma of colon presented as retroperitoneal mass.

Conclusion: In this case report we described this rare occurrence of leiomyosarcoma of colon and highlight the diagnostic difficulties such cases can pose along with a review of relevant literature.


Keywords


Leiomyosarcoma; Retroperitoneal; Colon; Surgical resection

References


Strauss DC, Hayes AJ, Thomas JM. Retroperitoneal tumours: review of management. Annals of the Royal College of Surgeons of England. 2011, 93(4):275-280

Van Roggen JF, Hogendoorn PC. Soft tissue tumours of the retroperitoneum. Sarcoma. 2000, 4 (1-2):17-26

Pacelli F, Tortorelli AP, Rosa F, Papa V, Bossola M, Sanchez AM, Ferro A, Menghi R, Covino M, Doglietto GB. Retroperitoneal soft tissue sarcoma: prognostic factors and therapeutic approaches. Tumori. 2008, 94 (4):497-504

Kono M, Tsuji N, Ozaki N, Matsumoto N, Takaba T, Okumura N, Kawasaki M, Tomita T, Umehara Y, Taniike S, Hatabe S, Funai S, Ono Y, Ochiai K, Maekura S, Kudo M. Primary leiomyosarcoma of the colon. Clinical journal of gastroenterology. 2015, 8 (4):217-222

Kiran P, Shiny PM, Dhanya KS, Aravindan KP. Diagnosis of leiomyosarcoma of colon. Journal of cancer research and therapeutics. 2015, 11(4):1035

Janevski V, Selmani R, Janevska V, Spasevska L, Zhivadinovik J. Leiomyosarcoma of the Colon. Medicinski pregled. 2015, 68(11-12):413-417

Hughes MJ, Thomas JM, Fisher C, Moskovic EC. Imaging features of retroperitoneal and pelvic schwannomas. Clinical radiology. 2005, 60(8):886-893

Wan Z, Yin T, Chen H, Li D. Surgical treatment of a retroperitoneal benign tumor surrounding important blood vessels by fractionated resection: A case report and review of the literature. Oncology letters. 2016, 11(5):3259-3264

Sun J, Yu XR, Shi BB, Zheng J, Wu JT. CT features of retroperitoneal solitary fibrous tumor: report of three cases and review of the literature. World journal of surgical oncology. 2014, 12:324

Pham V, Henderson-Jackson E, Doepker MP, Caracciolo JT, Gonzalez RJ, Druta M, Ding Y, Bui MM. Practical Issues for Retroperitoneal Sarcoma. Cancer control : journal of the Moffitt Cancer Center. 2016, 23 (3):249-264

Hogg HD, Manas DM, Lee D, Dildey P, Scott J, Lunec J, French JJ. Surgical outcome and patterns of recurrence for retroperitoneal sarcoma at a single centre. Annals of the Royal College of Surgeons of England. 2016, 98 (3):192-197

Hazen B, Cocieru A. Giant Retroperitoneal Sarcoma. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 2016, doi:10.1007/s11605-016-3258-0

Ipach I, von Weyhern CH, Kopp HG, Kunze B, Kluba T. Extremity leiomyosarcoma metastasizing to the large bowel as a pedunculated colon polyp. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2011, 29 (33):e799-802

Michalopoulos A, Papadopoulos VN, Basdanis G, Haralabopoulos E, Zatagias A, Netta S, Apostolidis S, Fahantidis E. Colorectal gastrointestinal mesenchymal tumours. Report of a stromal case of the rectum (GIST) and a leiomyosarcoma of the transverse colon. Techniques in coloproctology. 2004, 8 Suppl 1:s155-157

Nuessle WR, Magill TR, 3rd. Leiomyosarcoma of the transverse colon. Report of a case with discussion. Diseases of the colon and rectum. 1990, 33 (4):323-326

Mavrodontidis A, Zalavras C, Skopelitou A, Karavasilis V, Briasoulis E. Leiomyosarcoma as a second metachronous malignant neoplasm following colon adenocarcinoma. A case report and review of the literature. Sarcoma. 2001, 5 (1):31-33

Johnson MA, Gibbs DH, Gouldman J, Hanly M, Gadacz TR. Leiomyosarcoma of the colon: a second malignant neoplasm after treatment for a Wilms' tumor. The American surgeon. 1999, 65 (1):6-10

Iwasa K, Taniguchi K, Noguchi M, Yamashita H, Kitagawa M. Leiomyosarcoma of the colon presenting as acute suppurative peritonitis. Surgery today. 1997, 27 (4):337-344

Abdel Samie A, Sun R, Fayyazi A, Theilmann L. Leiomyosarcoma of the sigmoid colon: a rare cause of intestinal intussusception. Journal of gastrointestinal cancer. 2014, 45 Suppl 1:6-9

Hamai Y, Hihara J, Emi M, Aoki Y, Kushitani K, Tanabe K, Okada M. Leiomyosarcoma of the sigmoid colon with multiple liver metastases and gastric cancer: a case report. BMC gastroenterology. 2012, 12:98

Resch T, Oberhuber R, Zitt M, Laimer E, Gehwolf P, Pratschke J, Klaus A. Leiomyosarcoma of the colon: unresolved issues of a rare but highly aggressive malignancy. The American surgeon. 2011, 77 (4):E62-64

Garlipp B, Schulz HU, Zeile M, Lippert H, Meyer F. [Surgical management of retroperitoneal soft-tissue sarcomas--an overview]. Zentralblatt fur Chirurgie. 2010,135 (6):564-574

Drumea K, Sabo E, Zuckerman E, Naschitz JE. Leiomyosarcoma of the colon in the aftermath of pelvic irradiation for endometrial carcinoma. The American journal of gastroenterology. 1993, 88 (8):1302

Gladdy RA, Gupta A, Catton CN. Retroperitoneal Sarcoma: Fact, Opinion, and Controversy. Surgical oncology clinics of North America. 2016, 25 (4):697-711

Kirane A, Crago AM. The importance of surgical margins in retroperitoneal sarcoma. Journal of surgical oncology. 2016, 113 (3):270-276

Crago AM. Extended surgical resection and histology in retroperitoneal sarcoma. Annals of surgical oncology. 2015, 22 (5):1401-1403


Full Text: PDF

Refbacks

  • There are currently no refbacks.


AJCC-REP (ISSN 2572-5742)Copyright © 2012-2017. All rights reserved. Published by Ivy Union Publishing, 3204 Valley Rush Dr, Apex, North Carolina 27502, United States