Abstract
Leiomyosarcoma of the rectum is a rare entity. A case report of the disease is presented here. An 81-year-old woman was seen at the hospital because of anal hemorrhage. Digital rectal examination showed a mass in the anterior wall of the rectum. Proctosigmoidoscopy revealed an ulcerated tumor with the diameter of 2cm on the anterior wall of the rectum which was located 1cm from the anal verge. A biopsy was taken and histological examination confirmed leiomyosarcoma. MRI was performed to delineate the extent of the tumor, which suggested some invasion into the vagina. On September 3, 1996, an abdominoperineal resection of the rectum with lymph node dissection was carried out. The tumor invaded the vagina and a local resection of the vagina was performed. Histological examination showed leiomyosarcoma with a mitotic rate being three or more per 10 high power fileds on average. Some lymph nodes were positive for metastasis. Review of the literatur shows disagreement over the therapeutic approach, most likely due to a lack of large series of patients with this disease in each institute. Lesions less than 2.5cm in size located within the bowel wall can be treated by wide local excision. In our case, although the ulcerated tumor was 2cm in diameter, it extended outside the bowel wall. Therefore, we has to choose the abdominoperineal resection of the rectum with lymph node dissection that provided a good prognosis.
