Crystal Jessica S, Korderas Kristin, Schwartzberg David, Tizio Steven C, Zheng Min, Parker Glenn
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Monmouth Medical Center, Long Branch, NJ, USA.
Case Rep Surg. 2018 Jan 30;2018:6824643. doi: 10.1155/2018/6824643. eCollection 2018.
Primary leiomyosarcomas (LMS) of the colon are rare and aggressive neoplasms and have been infrequently reported in the literature. These tumors are more aggressive and have poorer prognoses than adenocarcinoma of the colon and are often mistaken as such on initial evaluation. While the former has a clear association with inflammatory bowel disease (IBD), this correlation is not known to exist with LMS and IBD. Nor is there a known link between LMS and the immunosuppression for IBD, despite the known association between malignancy and immunosuppression for other diseases. Due to the low prevalence of this disease entity, there is limited knowledge and literature on the approach to diagnosing and treating these neoplasms, especially in the setting of the aforementioned comorbidities. Here, we describe two cases of this rare entity, presenting in two different circumstances: one in the setting of immunosuppression for IBD and arthritis, with a synchronous urothelial carcinoma, and the second appearing as the source of an acute abdomen. Both diagnoses were established following pathologic analysis.
结肠原发性平滑肌肉瘤（LMS）是罕见的侵袭性肿瘤，文献报道较少。这些肿瘤比结肠腺癌更具侵袭性，预后更差，在初始评估时常被误诊为结肠腺癌。虽然前者与炎症性肠病（IBD）有明确关联，但LMS与IBD之间的这种相关性尚不清楚。尽管已知恶性肿瘤与其他疾病的免疫抑制有关，但LMS与IBD的免疫抑制之间也没有已知的联系。由于这种疾病实体的患病率较低，关于这些肿瘤的诊断和治疗方法的知识和文献有限，尤其是在上述合并症的情况下。在此，我们描述两例这种罕见疾病，呈现于两种不同情况：一例是在IBD和关节炎免疫抑制背景下，同时患有尿路上皮癌；另一例表现为急腹症的病因。两种诊断均经病理分析确定。
