A Case of Leiomyosrcoma of the Rectum

Abstract

A 69-year-old man suddenly presented anal bleeding. On digital rectal examination an elastic soft mass was palpated in the anteriol rectal wall. He was admitted to our hospital for further evaluation and treatment of the rectal tumor.
Endoscopic examination showed a tumor of approximately 6cm in diameter with necrotic lesion, protruding from the anterior wall of the rectum. A biopsy was performed and histological examination comfirmed leiomyosarcoma. Pervic computed tomography and magnetic resonance imaging showed a heterogenous mass with irregular limits, suggesting some invasion into the capsule of the prostate. Pelvic ultrasonography showed an interruption of the fatty layer between rectum and prostate. However, at endoscopic ultrasonography, heterogenous hyperechoic tumor existed in the fourth layer and there was no evidence of invasion into the prostate. Abdomioperineal resection was performed, and there was no invasion into the prostate.
Rectal leiomyosarcoma is a rare disease. We reported a case of leiomyosarcoma of the rectum. In this case endoscopic ultrasonography was useful for the choice of treatment.