Abstract
A 67-year-old woman who had been followed in our clinic for viral hepatitis type C was found to have an about 3-cm diameter tumor between the right hilus of the kidney and the second part of the duodenum at a periodic CT examination. She was asymptomatic. Retroperitoneal tumor or submucosal tumor of the duodenum was suspected and the tumor was resected by laparoscopic surgery. Since there was no communication between the tumor and the duodenum, it was determined to be a retroperitoneal tumor. The histopathological diagnosis was leiomyosarcoma. The postoperative course was uneventful and the patient has been free from recurrence as of 2 years 9 months after the operation.
Leiomyosarcoma is a rare neoplasm of the retroperitoneum and progresses silently. Often the tumors reach a large size before being diagnosed. Surgical resection is the first choice and complete removal of the tumor is important. So far only three cases resected by laparoscopic surgery, including our case, have been reported in Japan in a review of Web Japan Medical Abstractis Society. With a recent progression in imaging methods, retroperitoneal leiomyosarcomas which are still in a relatively small size like in this case will be increasingly detected. As malignant retroperitoneal tumors are often indistinguishable from benign tumors before surgery, laparoscopy-assisted resection of a retroperitoneal tumor must be done completely.
