Serra J, Garriga J, Escuder J, Alonso M, Piera J, Puig la Calle J
Service de Chirurgie Générale et Digestive, Hôpital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Espagne.
J Chir (Paris). 1987 Aug-Sep;124(8-9):450-3.
A case is reported of leiomyoma of rectum, a rare tumor since it is detected in 2 of 3000 rectal tumors. It occurs principally in patients between 40 and 50 years. The tumor is submucosal, is difficult to diagnose and biopsy is often valueless since it does not involve the tumor mass. The interest of the present case is that trans-rectal ultrasound imaging of the leiomyoma was performed. Differential histologic diagnosis between benign and malignant forms is a dilemma, these tumors being of slow growth with a marked tendency for recurrence and malignant degeneration. Treatment should always be surgical, with local resection if histology has excluded malignancy, followed by periodic surveillance. Radical surgery is indicated in malignant forms or for local recurrence of benign tumors.
本文报告一例直肠平滑肌瘤，该肿瘤较为罕见，在3000例直肠肿瘤中仅发现2例。它主要发生在40至50岁的患者中。肿瘤位于黏膜下层，难以诊断，活检往往毫无价值，因为它不涉及肿瘤肿块。本病例的意义在于对平滑肌瘤进行了经直肠超声成像检查。良性和恶性形式之间的组织学鉴别诊断是一个难题，这些肿瘤生长缓慢，具有明显的复发和恶性变倾向。治疗应始终采用手术方式，如果组织学检查排除恶性肿瘤，则进行局部切除，随后进行定期监测。对于恶性形式或良性肿瘤的局部复发，需进行根治性手术。
