Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Surgery, All India Institute of Medical Sciences, New Delhi, India
BMJ Case Rep. 2021 Sep 13;14(9):e244381. doi: 10.1136/bcr-2021-244381.
Small bowel malignant tumours make only 2% of all gastrointestinal (GI) malignancies. Small bowel leiomyosarcoma (LMS) is further rare, accounts for only 0.1%-3% fraction of these tumours. These cases can present as asymptomatic intra-abdominal mass, anaemia due to GI bleed or acute abdomen such as perforation peritonitis, intussusception and bowel ischaemia. Standard of care is surgical resection. Our case presented as large lobulated exophytic ileal LMS measuring 10.8×11×14.7 cm involving multiple small bowel loops and abutting right iliac vessels and uterus. Patient's clinical course was complicated with COVID-19 positivity, deep vein thrombosis and pulmonary thromboembolism. She was managed by preoperative anticoagulation followed by resection of the tumour with end ileostomy.
小肠恶性肿瘤仅占所有胃肠道（GI）恶性肿瘤的 2%。小肠平滑肌肉瘤（LMS）更为罕见，仅占这些肿瘤的 0.1%-3%。这些病例可表现为无症状的腹腔内肿块、因 GI 出血引起的贫血或急性腹痛，如穿孔性腹膜炎、肠套叠和肠缺血。标准治疗方法是手术切除。我们的病例表现为 10.8×11×14.7cm 的大分叶状外生回肠 LMS，累及多个小肠环，并紧贴右侧髂血管和子宫。患者的临床病程伴有 COVID-19 阳性、深静脉血栓形成和肺血栓栓塞。她在术前接受抗凝治疗，然后进行肿瘤切除和末端回肠造口术。
