A CASE REPORT OF LEIOMYOSARCOMA OF THE RECTUM WITH LIVER METASTASIS

Abstract

We report a case of leiomyosarcoma of the rectum with liver metastasis resected by a Miles operation and left hepatic lobectomy. A 67-year-old man was seen at the hospital because of difficult defecation and bloody stool. Barium enema and anoscopy revealed a submucosal tumor of the rectum with ulceration of which inferior margin was 5cm distant from the anal verge. By a needle biopsy, it was diagnosed histologically as leiomyosarcoma. The giant rectal tumor which occupied the entire pelvic cavity and a solitary lesion in S₄ segment of the liver were revealed by CT scan. The excised tumors by Miles operation followed by left hepatic lobectomy were 13×12cm and 10×9cm in size respectively and the both lesions had the central necrosis.
Leiomyosarcoma of the rectum is a relatively uncommom entity. Most of all grow expansively, and symptoms of this disease appear slowly. So, aggressive resections of the primary and metastatic lesions should be determinant prognostic factors.