Duodenal leiomyosarcoma: a rare entity

Authors

  • P. S. Shanthi Institute of General Surgery, RGGGH, Chennai, Tamil Nadu, India
  • Vikas C. Kawarat Institute of General Surgery, RGGGH, Chennai, Tamil Nadu, India
  • Adithi Shankar Institute of General Surgery, RGGGH, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20230994

Keywords:

Duodenum, Tumor, Leiomyosarcoma, Pancreaticoduodenectomy

Abstract

Tumours of the small intestine are among the rarer conditions as compared to other tumours of the gastrointestinal tract. Among these, sarcomas hold a much lesser number in proportion to adenocarcinomas. Leiomyosarcomas occurring in the small intestine constitute an even smaller number, accounting for about 1% of malignant mesenchymal lesions in the gastrointestinal tract. Within the spectrum of LMS of the small intestine, the more common location encountered is the ileum, followed by the duodenum. The second part of the duodenum is usually implicated in most studied and reported cases of duodenal LMS. These tumours are known for their aggressive nature and their often-delayed presentation due to ill- defined symptomatology and diagnostic challenges. As a result of the above, even a century after the first reported case, their prognosis is poor. Here we report a case of a 64-year-old female who presented with vague complaints of abdominal discomfort and dyspepsia for a month and was diagnosed to have a mass lesion in the 2nd and 3rd part of the duodenum. Intraoperatively, she was found to have two separate mass lesions in D1 and D3 and was subjected to a pancreaticoduodenectomy. The mass lesions were pathologically categorized as leiomyosarcomas of the first and third part of the duodenum.

References

Ho YN, Leong YP, Sakijan AS, Swaminathan M, Sarvananthan K. Duodenal leiomyosarcoma: a report of a rare and aggressive tumour. Singapore Med J. 1992 Jun;33(3):297-8.

Bianchi C, Ansaldo GL, Scajola P, Pandolfo N, Mattioli FP. Il leiomiosarcoma del duodeno: descrizione di un caso clinico [Leiomyosarcoma of the duodenum: description of a clinical case]. Ann Ital Chir. 1996 Jul-Aug;67(4):553-6. Italian.

Petralia GA, Hansen PD, Bowyer RC, Williamson RC. Duodenal leiomyosarcoma. Dig Surg. 1999;16(1):22-5.

Bouassida M, Beji H, Chtourou MF, Nechi S, Chaabane A, Touinsi H. Leiomyosarcoma of the small bowel: A case report and literature review. Int J Surg Case Rep. 2022 Jul 26;97:107456.

Jerraya, Hichem. (2013). Leiomyosarcoma of the Duodeno-Jejunal Angle: Two Case Reports and Literature Review. Surgical Science. 4. 313-316.

Tolman CJ. A rare case of small bowel leiomyosarcoma presenting with acute gastro-intestinal bleeding. BJR Case Rep. 2016 Dec 22;3(2):20160089.

Luis J, Ejtehadi F, Howlett DC, Donnellan IM. Leiomyosarcoma of the small bowel: 7)Report of a case and review of the literature. Int J Surg Case Rep. 2015;6C:51-4

Owada Y, Haji S, Asakura R, Yamada K, Kawasaki K, Ienaga T, Ikura Y, Iwai Y. [A Case Report of Resectable Leiomyosarcoma of the Duodenum Origin Invading to the Inferior Vena Cava]. Gan To Kagaku Ryoho. 2018 Jan;45(1):142-144. Japanese.

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Published

2023-03-31

Issue

Section

Case Reports