Jadhav Mahesh, Nivash T Hariram
Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Aug 15;16(8):e66973. doi: 10.7759/cureus.66973. eCollection 2024 Aug.
Small bowel malignant tumors, particularly leiomyosarcomas (LMSs), are rare and challenging to diagnose due to their asymptomatic nature in the initial stages. The lack of specific symptoms makes it difficult to differentiate LMSs from other gastrointestinal tumors. This report highlights the clinical presentation, diagnostic challenges, treatment, and prognosis of small bowel LMSs, specifically focusing on a rare case of jejunal LMS presented in a 75-year-old man, initially suspected as a gastrointestinal stromal tumor (GIST). Clinical examination, laboratory investigations, imaging studies, and histopathological analysis were performed to diagnose and treat the patient. The patient underwent surgical excision of the tumor with successful recovery. The histopathological analysis confirmed a high-grade LMS, and the patient was advised on adjuvant chemotherapy for further treatment. This case report emphasizes the importance of considering small bowel LMSs in the differential diagnosis of abdominal pain and highlights the challenges in diagnosing and treating these rare tumors. Early detection and appropriate management can improve the prognosis of patients with small bowel LMSs.
小肠恶性肿瘤,尤其是平滑肌肉瘤(LMS),较为罕见,且由于其在初始阶段无症状,诊断颇具挑战性。缺乏特异性症状使得LMS难以与其他胃肠道肿瘤相鉴别。本报告重点介绍了小肠LMS的临床表现、诊断挑战、治疗及预后,特别聚焦于一名75岁男性患者所患的罕见空肠LMS病例,该病例最初被怀疑为胃肠道间质瘤(GIST)。通过临床检查、实验室检查、影像学研究及组织病理学分析对患者进行诊断和治疗。患者接受了肿瘤手术切除,恢复良好。组织病理学分析证实为高级别LMS,并建议患者接受辅助化疗以进一步治疗。本病例报告强调了在腹痛鉴别诊断中考虑小肠LMS的重要性,并突出了诊断和治疗这些罕见肿瘤的挑战。早期检测和适当管理可改善小肠LMS患者的预后。