Yang Jing
The First Department of General Surgery, Gansu Provincial Hospital, Lanzhou, Gansu Province, China.
Medicine (Baltimore). 2018 Feb;97(7):e9923. doi: 10.1097/MD.0000000000009923.
Leiomyosarcoma (LMS) is a common type of soft tissue sarcoma. Primary colonic LMS in general is a very rare entity, accounting for 1% to 2% of gastrointestinal malignancies.
We report a case of 55-year-old female who presented with a sudden onset of sharp right lower quadrant abdominal pain. Electronic colonoscopy showed a normal lumen. However, an abdominal computed tomography scan revealed a mass of soft tissue attenuation inseparable from the ascending colon which appeared as a gastrointestinal stromal tumor (GIST).
It is important to diagnose LMS definitively by immunohistochemical profiling of smooth muscle actin, desmin, and CD34.
She underwent laparotomy and right hemicolectomy, and histology confirmed a colonic LMS. The patient received no oncological treatment after surgery.
No recurrence or metastasis was observed at 5 months postoperatively. It is crucial to identify colonic LMS precisely based on immunohistochemistry, and thereby distinguish it from GIST.
Further investigation on LMS cases so far is required to establish standard treatment strategies.
平滑肌肉瘤（LMS）是一种常见的软组织肉瘤类型。原发性结肠LMS总体上是一种非常罕见的实体，占胃肠道恶性肿瘤的1%至2%。
我们报告一例55岁女性，她突然出现右下腹剧痛。电子结肠镜检查显示肠腔正常。然而，腹部计算机断层扫描显示一个与升结肠相连的软组织密度肿块，看起来像是胃肠道间质瘤（GIST）。
通过平滑肌肌动蛋白、结蛋白和CD34的免疫组织化学分析来明确诊断LMS很重要。
她接受了剖腹手术和右半结肠切除术，组织学证实为结肠LMS。患者术后未接受肿瘤治疗。
术后5个月未观察到复发或转移。基于免疫组织化学精确识别结肠LMS并将其与GIST区分开来至关重要。
目前需要对LMS病例进行进一步研究以制定标准治疗策略。
