A Case of Leiomyoma in the Small Intestinal Mesentery

Atsushi Adachi, Keijirou Tsutsui, Naofumi Takano and Tetsuji Uchiyama

Department of Surgery, Iwakuni Medical Center Hospital

Leiomyoma of the small intestinal mesentery is very rare, and we report only the 15th case, to our knowledge, in the Japanese literature. A 66-year-old man with a full sensation of the abdomen and constipation was hospitalized for an intraabdominal mass. Physical examination showed a 14×11×14 cm elastic, hard, movable smooth tumor generating pain upon pressure palpable in the left lower abdomen. Ehography, CT, and MRI showed a well-defined, lobular tumor with a heterogeneous internal structure. A small-intestine series showed only pressure to the small intestine due to the tumor. Angiography showed a dilated, crooked ileocolic artery. Upon laparotomy, the tumor was present in the small intestinal mesentery and had no invasive lesion. Partial intestinal excision revealed a 14×11×14 cm lobular, elastic, hard tumor. Histopathological and immunohistological studies showed c-kit (-), CD34 (-), S100 (-), and desmin (+). Leiomyoma arising in the small intestinal mesentery was the definitive diagnosis. The postoperative course was uneventful and he has been free from recurrence, but 10% level in MIB 1 level index requires careful follw-up.

Key words
leiomyoma of the small intestinal mesentery

Reprint requests
Atsushi Adachi Iwakuni Medical Center Hospital
3-6-12 Muronoki, Iwakuni, 740-0021 JAPAN

Accepted
September 28, 2005

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