Clinicopathological Studies of Leiomyosarcoma of the Small Intestine

Abstract

Leiomyosarcomas of the small intestine are rarely observed, selection of the operative procedure for this disease and its histological malignancy remain to be established. We evaluated 16 patients (11 males and 5 females) with leiomyosarcoma of the small intestine encountered in the Surgical Department of the Ogaki Municipal Hospital. Their mean age was 56. 1 years. Nonspecific symptoms and signs such as abdominal pain, a palpable abdominal mass, and decreased appetite were frequently observed, and a definite preoperative diagnosis was made in only 7. We classified lymph nodes of the small intestine according to the General Rules for the Clinical and Pathological Studies on Cancer of Large Intestine. R₀ (resection with no lymph node dissection) was performed in 6 patients, R₁ (resection with level 1 lymph node dissection) in 3, R₂ in 6 and R₃ in 1. Of the 7 patients who underwent R₂ or more, 2 showed metastasis to N₁ lymph node histologically. These results suggest that R₂ or more is recommended for leiomyosarcomas of the small intestine. As indices of tumor malignancy, mitotic figures and tumor diameter seemed important.