Vandoni R E, Givel J C, Essinger A R
Service de Chirurgie, CHUV, Lausanne, Switzerland.
Eur J Surg. 1992 Jun-Jul;158(6-7):383-6.
Rectal leiomyosarcoma is rare, often large and found in the distal third of the rectum. Most symptoms differ from those of an adenocarcinoma. Staging is difficult and should include tumour size, necrosis, cellularity, number of mitoses and anaplasia. Abdominoperineal excision (APE) remains the only effective treatment. A 66 year old asymptomatic female presented with painless rectal bleeding after a fall. Digital examination and proctoscopy revealed a mass on the posterior rectal wall. Pelvic ultrasonography, arteriography and CT-Scan showed a huge retro-rectal lesion. Following APE, histopathology confirmed a leiomyosarcoma. No adjuvant therapy was given; there is no recurrence 4 years later.
直肠平滑肌肉瘤较为罕见，通常体积较大，多位于直肠远端三分之一处。其多数症状与腺癌不同。分期困难，应包括肿瘤大小、坏死情况、细胞密度、有丝分裂数量及间变程度。腹会阴联合切除术（APE）仍是唯一有效的治疗方法。一名66岁无症状女性在跌倒后出现无痛性直肠出血。直肠指检和直肠镜检查发现直肠后壁有一肿物。盆腔超声、动脉造影及CT扫描显示直肠后方有一巨大病变。行APE术后，组织病理学确诊为平滑肌肉瘤。未给予辅助治疗；4年后无复发。
