A Case of Leiomyosarcaoma with Rapid Growth in the Mesosigmoid

Koutarou Maeda, Mitsumasa Hashimoto, Hitoshi Katai, Junichi Koh, Osami Yamamoto, Youichirou Hosoda, Yoshimune Horibe*

Department of Surgery and Pathology*, Soical Insurance Saitama Chuo Hospital

A case of rapidly growing leiomyosarcoma in the mesosigmoid is reported. A 73-year-old male was examined in another hospital by abdominal CT and echosonography 3 months previously under suspicion of metastatic brain tumor. No pathological findings were noted at the time. The patient was admitted to our hospital with a month's history of constipation and abdominal mass. The abdominal tumor,20 cm in diameter, was diagnosed as sarcoma in the mesosigmoid by CT and angiography, and the operation was performed. The tumor, which was located mainly in the mesosigoid, invaded to the mesorectum, ileum and appendix. A part of the tumor ruptured, and 3000 ml of bloody ascites was observed. Low anterior resection with partial resection of the ileum and appendectomy was performed. The tumor was 22×17×8 cm in size and 1750 g in weight, and was diagnosed histopathologically as leiomyosarcoma in the mesosigmoid. The patient was discharged uneventfully on the 14th postoperative day. Liver metastases and intraabdominal recurrence were discovered 5 months after the initial operation. The patient died 10 months after the operation in spite of chemotherapy. Leiomyosarcoma in the mesentery is a disease with poor prognosis, but only surgical intervention is considered to be curative and improve the patient's quality of life. Anemia of moderate grade was suggested to be a characteristic finding of leiomyosarcoma from our analysis of literature.

Key words
leiomyosarcoma in the mesentery, leiomyosarcoma with rapid growth

Reprint requests
Koutarou Maeda Department of Surgery, Soical Insurance Saitama Chou Hospital
4-9-3 Kitaurawa, Urawa, 336 JAPAN

Accepted
June 14, 1993

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