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Zhou J, Xu H, Hu J, Hong Q, Yu X, Liu W, Zhao J, Hu H. Current landscape of primary small bowel leiomyosarcoma: cases report and a decade of insights. Front Oncol 2024; 14:1408524. [PMID: 38846972 PMCID: PMC11153743 DOI: 10.3389/fonc.2024.1408524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/09/2024] [Indexed: 06/09/2024] Open
Abstract
The incidence of leiomyosarcoma (LMS) is about 4-5/100,000 individuals per year. LMSs occurring in the small bowel are even rarer, and their preoperative diagnosis is very difficult. We described two patients with pathologically confirmed small bowel LMS and analyzed their clinical and medical imaging features. Similar cases reported in English in Pubmed database over the past decade were reviewed and summarized. These tumors were categorized by the growth direction and relationship with the intestinal lumen into three types: intraluminal (n = 10), intermural (n = 3), and extraluminal (n = 7). Notably, among the three types of LMS, the intramural leiomyosarcoma stands out as a noteworthy subtype. Emerging evidence suggests that smaller tumor size (< 5 cm) and the intraluminal type may serve as favorable prognostic indicators, while the extraluminal type is associated with relatively poor prognosis. Furthermore, the integration of imaging features with CA125 and LDH biomarkers holds promise for potential diagnostic value in LMS.
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Affiliation(s)
- Junjie Zhou
- Department of Radiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Houyun Xu
- Department of Radiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Jibo Hu
- Department of Radiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Qiang Hong
- Department of General Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Xiping Yu
- Department of Pathology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Wei Liu
- Department of Radiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Jiaxin Zhao
- Department of General Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Yu HW, Yan JG, Zheng L, Huang JH. Ileum intussusception secondary to submucosal liposarcoma in adult:A case report. Heliyon 2024; 10:e23432. [PMID: 38192766 PMCID: PMC10772086 DOI: 10.1016/j.heliyon.2023.e23432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024] Open
Abstract
Intussusception in adults is a rare surgical emergency. Unlike in children, most adult intussusceptions arise from a pathological lead point. Ileal intussusception caused by a submucosal liposarcoma is a particularly rare phenomenon. This report describes the diagnosis and management of adult ileal intussusception secondary to submucosal liposarcoma in adult to provide a reference for future clinical work. A 64-year-old female presented to the emergency department with worsening abdominal pain associated with an 8 h history of intermittent vomiting. Based on physical examination, laboratory investigations, and computed tomography, the most likely diagnosis was ileal intussusception secondary to liposarcoma. Thus, emergency laparotomy was performed. During exploration, an ileal invagination was visualised approximately 30 cm from the ileocecal valve, and a flexible polypoid mass was palpable at the lead point of the intussusception. Subsequently, the patient underwent radical resection of pathological tissues with a primary end-to-end ileal anastomosis. Histopathological examination revealed a well-differentiated submucosal liposarcoma. Postoperatively, the patient recovered uneventfully and was doing well at the 6-month follow-up in the outpatient clinic. Thus, clinicians should consider the origin of submucosal liposarcomas in adult with intussusception. Once ileal intussusception secondary to submucosal liposarcoma is diagnosed, timely radical resection is recommended.
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Affiliation(s)
- Hong-wei Yu
- Division of Gastrointestinal Surgery, Wenzhou Medical University Affiliated Zhoushan Hospital, Zhoushan, Zhejiang Province, China
| | - Jin-gang Yan
- Division of Gastrointestinal Surgery, Wenzhou Medical University Affiliated Zhoushan Hospital, Zhoushan, Zhejiang Province, China
| | - Lei Zheng
- Division of Gastrointestinal Surgery, Wenzhou Medical University Affiliated Zhoushan Hospital, Zhoushan, Zhejiang Province, China
| | - Jun-hua Huang
- Division of Gastrointestinal Surgery, Wenzhou Medical University Affiliated Zhoushan Hospital, Zhoushan, Zhejiang Province, China
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