Beauchamp Amélie, Hajjar Roy, Khullar Sharmila, Latour Mathieu, Schwenter Frank, Sebajang Herawaty
Department of Surgery, Université de Montréal, Montreal, Canada.
Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada.
Case Rep Surg. 2020 Mar 23;2020:6935834. doi: 10.1155/2020/6935834. eCollection 2020.
Primary colorectal leiomyosarcoma is an excessively rare entity. It is associated with an aggressive behavior and typically favor hematogenous spread. The current standard of care is surgical resection. A 49-year-old patient presented with a 2-month history of fever. A PET-scan revealed a hypermetabolic mass in the transverse colon, and colonoscopy confirmed a tumor. A right hemicolectomy was performed. Histopathological diagnosis was of a leiomyosarcoma. Fourteen months after the surgery, a follow-up abdominal scan revealed a 2 cm mesenteric lymph node that was hypermetabolic on PET-scan. The mesenteric lymph node was resected and histopathology confirmed a leiomyosarcoma metastasis. This case opens the controversy on the management of rare lymph node recurrences in colorectal leiomyosarcoma.
原发性结直肠平滑肌肉瘤是一种极其罕见的疾病。它具有侵袭性，通常倾向于血行转移。目前的标准治疗方法是手术切除。一名49岁患者有2个月的发热病史。PET扫描显示横结肠有一个高代谢肿块，结肠镜检查证实为肿瘤。进行了右半结肠切除术。组织病理学诊断为平滑肌肉瘤。手术后14个月，腹部随访扫描显示一个2厘米的肠系膜淋巴结，PET扫描显示其代谢活跃。切除该肠系膜淋巴结，组织病理学证实为平滑肌肉瘤转移。该病例引发了关于结直肠平滑肌肉瘤罕见淋巴结复发治疗的争议。
