DOI: 10.36347/sjmcr.2017.v05i11.019

Pages: 759-761

Primary gastrointestinal (GI) sarcomas in general are a very rare entity. Leiomyosarcoma (LMS) is the most common histiotype of this group of malignant neoplasms. Intestinal LMS are mesenchymal tumors of smooth muscle origin which occur mainly in the fifth and sixth decades of life. Abdominal pain and GI bleeding are the most common common presentation, but some of them present with intestinal obstruction. We present a case of an 80-year-old male who presented to us with acute intestinal obstruction, with otherwise unremarkable past medical history. CT scan thorax/abdomen/pelvis showed distal jejunal intussusception with a small bowel lesion. He underwent laparotomy which revealed a small bowel intussusception, with a 5cmx4cmx2cm pedunculated intra-luminal tumour as the leading point. Small bowel resection and end to end anastomosis were done. HPE confirmed a poorly differentiated leiomyosarcoma, with expression of Vimentin, Caldesmon and SMA in the immunohistochemistry. Early diagnosis of small bowel LMS remains a challenge considering the non-specific or sub-acute symptoms. Although CT scan is useful in confirming an anatomical abnormality, final diagnosis requires histopathological analysis. The treatment of such tumours remains predominantly centered on surgical resection and prognosis is dependent on tumour size and histological staging.