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2.1
Anal Leiomyosarcoma

Presentation

[…] patients were symptomatic at presentation. [saudijgastro.com]

Clinical History 76 year old female presents with painful defecation, rectal bleeding and iron deficient anaemia. Lower GI endoscopy revealed a rectal mass. [eurorad.org]

The patient did not present important complications in the immediate postoperative period. [scielo.br]

Since smooth muscle is present throughout the body, leiomyosarcoma can occur anywhere in the body. [mdanderson.org]

Entire Body System

  • Surgical Procedure

    Wide local excision was performed in 10 patients, whereas a more radical surgical procedure, including abdominoperineal resection (n=8), pelvic exenteration (n=2), and low anterior resection (n=1), were performed in 11 patients. [link.springer.com]

    Five months after the surgical procedure, in a radiological follow-up, abdominal ultrasound and abdominal-pelvic CT without contrast, due to deterioration of the renal function, revealed pleural effusion, ascites, hepatomegaly as well as multiple well-defined [ncbi.nlm.nih.gov]

  • Asymptomatic

    Often these tumors are initially asymptomatic due to their submucosal origin. Clinical diagnosi depends on awareness of these lesions, digital rectal examination, endoscopic examination, and tissue biopsy. [link.springer.com]

    The presenting symptoms are rectal pain, constipation, rectal fullness, and diarrhea, although some patients may be asymptomatic [3]. [ovarianresearch.biomedcentral.com]

  • Anemia

    The laboratory tests carried out showed anemia (Hemoglobin 9 gr/dL and Hematocrit 29.4%), Leukocytosis (14,800 per mm3), increased Alkaline phosphatase (186.4 mg/dL) and AST and ALT formerly are called serum glutamic oxaloacetic transaminase (GOT) and [ncbi.nlm.nih.gov]

    Laboratory work revealed leukocytosis of 20,800 cells/mL and anemia with a hemoglobin value of 10.8 g/dL. The patient underwent an emergent exploratory laparotomy in the setting of his acute peritonitis. [hindawi.com]

Respiratoric

  • Pleural Effusion

    Our patient had one regional lymph node infiltrated by the tumor when the low anterior resection was performed and multiple metastatic hepatic nodules, pleural effusion and ascites were detected in the follow-up studies, there were no signs of other solid [ncbi.nlm.nih.gov]

Gastrointestinal

  • Rectal Bleeding

    Clinical History 76 year old female presents with painful defecation, rectal bleeding and iron deficient anaemia. Lower GI endoscopy revealed a rectal mass. [eurorad.org]

    These unusual tumors cause symptoms similar to those of more common anorectal diseases, namely, painful defecation and rectal bleeding. Often these tumors are initially asymptomatic due to their submucosal origin. [link.springer.com]

    Eight years later, with no apparent recurrence, the patient presented with rectal tenesmus associated with rectal bleeding. [revistagastroenterologiamexico.org]

    […] even in the absence of rectal bleeding or pain. [ovarianresearch.biomedcentral.com]

    Case presentation A 90-year-old man presented in 2013 with bright red bleeding per rectum and rectal pain. Thirteen years prior, he was diagnosed with a T2 N0 stage 2 squamous cell anal cancer after symptoms of rectal bleeding. [ncbi.nlm.nih.gov]

  • Constipation

    Case report: An 80-year-old male presented with a complaint of bright red blood per rectum, constipation, and a subjective history of a rectal mass diagnosed 3 years prior. [pubmed.ncbi.nlm.nih.gov]

    No definite history of constipation or alteration in bowel habits was present. She had consulted a surgeon 6 months ago, with similar complaints, who had diagnosed spindle cell tumor of anal canal based on a cytology report. [saudijgastro.com]

    He presented with a 1-year history of rectorrhagia and constipation. [jmedicalcasereports.biomedcentral.com]

    CASE REPORT A 70-year-old male patient, with history of tenesmus, recent intestinal constipation and hematochezia with 3-month progression. [scielo.br]

    Initial symptoms include abdominal pain, rectal bleeding, intra-abdominal bleeding, weight loss, constipation, diarrhea, bowel obstruction, tenesmus, or fever, which are nonspecific, generally reflect the tumor size and location, and can mimic those symptoms [hindawi.com]

  • Rectal Mass

    Clinical History 76 year old female presents with painful defecation, rectal bleeding and iron deficient anaemia. Lower GI endoscopy revealed a rectal mass. [eurorad.org]

    Case report: An 80-year-old male presented with a complaint of bright red blood per rectum, constipation, and a subjective history of a rectal mass diagnosed 3 years prior. [pubmed.ncbi.nlm.nih.gov]

    We report the case of a 61 years old male patient without previous medical conditions, with melena and constitutional symptoms and an extensive rectal mass with a final diagnosis of diagnosis leiomyosarcoma of the large intestine, grade II (FNCLCC). [ncbi.nlm.nih.gov]

    On physical examination we found a mass in his rectum approximately 6 cm from his anal margin. Pelvic magnetic resonance imaging showed a rectal mass with a parietal attachment that invaded the fascia and his perirectal tissue. [jmedicalcasereports.biomedcentral.com]

    A digital rectal examination revealed a large rectal mass in the posterolateral wall that could not be moved, and the mass was approximately 3 cm from his anal margin. [tcr.amegroups.com]

  • Hematochezia

    CASE REPORT A 70-year-old male patient, with history of tenesmus, recent intestinal constipation and hematochezia with 3-month progression. [scielo.br]

Cardiovascular

  • Hypertension

    He had an extensive past medical history including atrial fibrillation, obesity, hypertension, chronic kidney disease, hyperlipidemia, left ventricular hypertrophy, benign prostatic hyperplasia, and aortic and mitral valve disease. [hindawi.com]

    He had a medical history of hypertension and type II diabetes mellitus, no surgical history and a family history of genetic diseases. [tcr.amegroups.com]

Psychiatrical

  • Aggressive Behavior

    It is possible that the poor prognosis of these immunosuppressed patients with tumors may be related to delays in diagnosis in these patients and to the exceptionally aggressive behavior of smooth muscle tumors in the setting of their damaged immune systems [hindawi.com]

Workup

The preoperative metastatic workup did not report abnormalities. Axial image of abdominal CT with contrast that shows a solid heterogeneous mass in the rectosigmoid junction (white arrow). [ncbi.nlm.nih.gov]

Pleura

  • Pleural Effusion

    Our patient had one regional lymph node infiltrated by the tumor when the low anterior resection was performed and multiple metastatic hepatic nodules, pleural effusion and ascites were detected in the follow-up studies, there were no signs of other solid [ncbi.nlm.nih.gov]

Treatment

Treatment by Cancer Type NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) are posted with the latest update date and version number. The NCCN Guidelines are copyrighted by the NCCN. All rights reserved. [nccn.org]

Due to its rarity, the standard treatment has not been defined. The purpose of this study was to present the follow-up of a patient with leiomyosarcoma of medium rectum submitted to exclusive operative treatment. [scielo.br]

What are the treatment options for leiomyosarcoma? Surgery is the mainstay of treatment for leiomyosarcoma, but radiation therapy and chemotherapy are often used in conjunction with surgery. [mdanderson.org]

Treatment The patient was offered surgical management via abdominoperineal resection, but he declined. [ncbi.nlm.nih.gov]

Surgery is the treatment of choice that offers the best oncologic results in these cases. [revistagastroenterologiamexico.org]

Prognosis

What is the prognosis for someone diagnosed with leiomyosarcoma? The prognosis for leiomyosarcoma varies greatly depending on the stage of disease. Size and metastatic spread are key factors in leiomyosarcoma. [mdanderson.org]

Conclusion In conclusion, leiomyosarcoma of the colon is a rare and aggressive neoplasm with poor prognosis. It can mimic other tumors and GI diseases but should be distinguished as a separate entity as the prognosis and treatment vary. [hindawi.com]

Leiomyosarcoma has a poor prognosis, with a 5-year survival rate of 30% in the minority of patients without associated risk factors. [scielo.org.co]

Prognosis is also poor; tumor size, histological grade, mitotic index, and local staging are the most known prognosis factors. [jmedicalcasereports.biomedcentral.com]

Using a histological grading system that included tumour differentiation, mitotic count and amount of necrosis, high grade sarcomas were associated with a worse prognosis. [pubmed.ncbi.nlm.nih.gov]

Etiology

[…] has currently been shown that the period can be shorter, with the appearance of radiation-induced tumors from 6 months to 20 years after treatment completion.3 It is known that the development of these tumors is the result of the interaction of many etiologic [revistagastroenterologiamexico.org]

Epidemiology

Definition / general Smooth muscle tumor with atypia plus either mitotic activity, tumor cell necrosis or size > 10 cm 10% of adult soft tissue sarcomas Variants are described separately above Epidemiology Skin / subcutis: see cutaneous variants above [pathologyoutlines.com]

A population- based epidemiologic and prognostic study of 48 patients, including cellular DNA content. [ncbi.nlm.nih.gov]

Prevention

Wide local resection was not superior to a more radical surgical approach in preventing tumor recurrence or improving survival. [link.springer.com]

The high risk of CRC is attributed to three main factors: the carcinogenic effect of chronic mucosal inflammation, genetic predisposition, and environmental factors. 1,2 To prevent morbidity and mortality associated with CRC in patients with IBD, endoscopic [scielo.org.co]

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