Eriguchi N, Aoyagi S, Hara M, Tanaka E, Hashimoto M
Department of Surgery, Kurume University School of Medicine, Japan.
Kurume Med J. 1998;45(1):137-41. doi: 10.2739/kurumemedj.45.137.
A 63 year-old-man was admitted to our hospital with the chief complaint of dyschezia. Digital examination revealed a large solid mass on the posterior wall of the rectum. Endoscopically, the tumor was covered by an intact mucosal layer. Under the diagnosis of rectal leiomyosarcoma, abdominoperineal resection of the rectum was performed. The tumor was 10 x 9 x 8 cm in size, and its cross section showed a gray-white tumor with central necrosis. Microscopically, the large tumor of the rectum was mainly located in the proper muscle layer and adventitia, and showed cellular proliferation of spindle-shaped and mild pleomorphic stromal cells, arranged in interlacing fashion, and focal necrosis. The histologic findings support the diagnosis of leiomyosarcoma. Leiomyosarcoma of the rectum is a relatively uncommon disease. We report our case with reference to the literature.
一名63岁男性因排便困难为主诉入院。直肠指诊发现直肠后壁有一巨大实性肿物。内镜检查显示肿瘤被完整的黏膜层覆盖。在诊断为直肠平滑肌肉瘤后，行腹会阴联合直肠癌根治术。肿瘤大小为10×9×8cm，其横断面显示为灰白色肿瘤伴中央坏死。显微镜下，直肠的巨大肿瘤主要位于固有肌层和外膜，可见梭形细胞及轻度多形性间质细胞呈细胞增殖，呈交错排列，并伴有局灶性坏死。组织学表现支持平滑肌肉瘤的诊断。直肠平滑肌肉瘤是一种相对罕见的疾病。我们结合文献报道此病例。
