Recurrent Leiomyosarcoma of the Small Bowel: A Case Series

Anticancer Res. 2020 Jul;40(7):4199-4204. doi: 10.21873/anticanres.14420.

Abstract

Background/aim: Leiomyosarcoma is an extremely rare, small bowel neoplasm (2% of all gastrointestinal tumours). Early diagnosis is challenging due to the slow growth of the cancer. The biological behaviour of this group of tumours is aggressive, and the first-line treatment is surgical resection.

Patients and methods: This is a report of 4 cases of small bowel leiomyosarcoma that were treated in the last ten years at Hospital San Martino: one involving the jejunum and three involving the ileum (age range=69-86 years). Three patients underwent surgical resection and one was treated with chemotherapy.

Results: All patients who were eligible for surgery underwent radical resection with R0 margins. Mean overall survival was 33 months (range=8-84 months).

Conclusion: Specific guidelines for small bowel leiomyosarcoma do not currently exist and these rare cases should be discussed in a multidisciplinary context. The first treatment approach is surgery, and in some cases, multivisceral resection may be needed to obtain free margins, even in recurrent cases.

Keywords: Leiomyosarcoma; oncological surgery; sarcoma; small bowel.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intestinal Neoplasms / diagnostic imaging
  • Intestinal Neoplasms / drug therapy
  • Intestinal Neoplasms / pathology
  • Intestinal Neoplasms / surgery*
  • Leiomyosarcoma / diagnostic imaging
  • Leiomyosarcoma / drug therapy
  • Leiomyosarcoma / pathology
  • Leiomyosarcoma / surgery*
  • Male