A Case Report of Ileum Leiomyosarcoma Presenting As Multiple Liver Abscess

Kanji Ishihara, Norio Suzuki, Ryo Itou, Masataka Eirai, Masahiro Nishikawa, Mamoru Oomura, Masanao Ueda, Koushi Nagano and Hirokazu Fujii

Department of Surgery Ishikiriseiki Hospital

Because of its' anatomical location and frequency, it is relatively difficult to determine a preoperative diagnosis of ileal leiomyosarcoma without abdominal symptoms, such as melena. A 53-year-old woman who had been treated for multiple liver abscesses in another hospital was referred to our hospital with a pelvic mass suggestive of gynecologic neoplasm. Pelvic MRI showed a 6×6 cm irregular mass at the dorsal side of the bladder, and anterior to the uterus and rectum, Under a presumed diagnosis of solid ovarian tumor, a gynecologist performed a laparotomy. However, the tumor originated in the small intestine, and she was transferred to another surgeon. Partial ileal resection with tumor was carried out. The histological diagnosis was ileal leiomyosarcoma. since 1985 in Japan, 12 cases of small-bowel tumor presenting with liver abscess were reported. In our case, Streptococcus intermedius was found in the liver abscess. Physicians should consider small-bowel tumor, in-patients presenting with pelvic mass and liver abscess due to small intestinal bacteria.

Key words
leiomyosarcoma of small intestine, liver abscess, streptococcus

Reprint requests
Kanji Ishihara Department of Surgery, Ishikiriseiki Hospital 18-28 Yayoicyou Higashioosaka City, 579-8026 JAPAN

Accepted
July 24, 2002

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