Nieuwland Claudia, Pajaro Rafael
Internal Medicine, Morristown Medical Center, Morristown, USA.
Medical School, St. George's University School of Medicine, St. George's, GRD.
Cureus. 2024 Sep 18;16(9):e69644. doi: 10.7759/cureus.69644. eCollection 2024 Sep.
Gastrointestinal (GI) leiomyomas, particularly those located in the rectum, are extremely rare, accounting for approximately 0.1% of rectal tumors. We report the case of a middle-aged female who presented with chronic diarrhea of unknown origin. A colonoscopy was performed, during which a rectal polyp was resected. Histopathology examination of the polyp revealed smooth muscle proliferation and a positive immunohistochemical profile for desmin, consistent with leiomyomatous nature and a diagnosis of rectal leiomyoma. This case underscores the importance of a comprehensive diagnostic approach, including endoscopic, histologic, and immunohistochemical analysis, to differentiate leiomyomas from other GI tumors. Following GI evaluation, the patient underwent a total abdominal hysterectomy, which revealed multiple uterine leiomyomas. The concurrent presence of rectal and uterine leiomyomas in this patient is significant and suggests a potential association between these lesions in females. Further research is needed to explore the potential relationship between rectal and uterine leiomyomas and its implications for clinical practice.
胃肠道平滑肌瘤,尤其是位于直肠的平滑肌瘤极为罕见,约占直肠肿瘤的0.1%。我们报告了一例中年女性患者,她出现了病因不明的慢性腹泻。进行了结肠镜检查,期间切除了一个直肠息肉。息肉的组织病理学检查显示平滑肌增生,结蛋白免疫组化结果呈阳性,符合平滑肌瘤性质,诊断为直肠平滑肌瘤。该病例强调了采用包括内镜、组织学和免疫组化分析在内的综合诊断方法来区分平滑肌瘤与其他胃肠道肿瘤的重要性。经过胃肠道评估后,患者接受了全腹子宫切除术,术中发现多个子宫平滑肌瘤。该患者同时存在直肠和子宫平滑肌瘤具有重要意义,提示女性这些病变之间可能存在关联。需要进一步研究来探讨直肠和子宫平滑肌瘤之间的潜在关系及其对临床实践的影响。