Leiomysarcoma of the Rectum-Report of a Recurrent Case Four Years after Enucleation

Abstract

A case of leiomyosarcoma is reported which recurred at the enucleation site four years after surgery. On the first occasion, the patient, a 47-year-old man, visited our clinic with a complaint of anal pain. Enucleation was performed following a diagnosis of submucosal tumor which occupied one third of the rectal circumference. The histological diagnosis was leiomyoma. Four years later, leiomyosarcoma was found at the same site ; after diagnosis, abdominoperineal resection was performed. Microscopically, the specimen obtained at the first admission showed minor cellular atypism, lack of marked cellularity and few mitoses. It is often difficult to distinguish benign from malignant smooth muscle tumors. Close follow-up and radical surgery when necessary are important in those patients.