Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
A CASE OF LEIOMYOSARCOMA OF THE DUODENUM CAUSING MULTIPLE PYOGENIC LIVER ASSCESSES
Nobuhiro TOKUNAGAHisao NAKAZAKIJinichi SOEDAHikaru TANAKATakafumi SEKKASotaro SADAHIROTomoo TAJIMAHiroyasu MAKUUCHI
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1998 Volume 59 Issue 2 Pages 473-476

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Abstract
A case of leiomyosarcoma of the duodenum causing multiple pyogenic liver abscess is reported. A 55-year-old man was admitted to the hospital because of lasting fever of unknown orign. Ultrasound scan of the abdomen revealed multiple low density areas in the liver parenchyma, also seen CT scanning as multiple areas of low attenuation coefficient. And CT scanning of the abdomen depicated a duodenal hypervascular mass measuring 4.0cm in diameter. Duodenoscopy revealed a submucosal tumor with ulceration. The clinical presentation was consistent with that of liver abscess. But the possibility of the necrotic hepatic metastases could not be ruled out. Pancreatoduodenectomy was performed. Histopathologically this tumor was leiomyosarcoma arising from the descending portion of the duodenum with multiple pyogenic hepatic abscesses. It is etiologically thought that the leiomyosarcoma was associated with central necrosis which had a communication with gastrointestinal lumen to form infectious foci locally, and the infection affected the liver via portal veins to form liver abscesses.
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