Primary Leiomyosarcoma of the Colon: A Report of Two Cases, Review of the Literature, and Association with Immunosuppression for IBD and Rheumatoid Arthritis

Case Reports in Surgery
Jessica S CrystalGlenn Parker

Abstract

Primary leiomyosarcomas (LMS) of the colon are rare and aggressive neoplasms and have been infrequently reported in the literature. These tumors are more aggressive and have poorer prognoses than adenocarcinoma of the colon and are often mistaken as such on initial evaluation. While the former has a clear association with inflammatory bowel disease (IBD), this correlation is not known to exist with LMS and IBD. Nor is there a known link between LMS and the immunosuppression for IBD, despite the known association between malignancy and immunosuppression for other diseases. Due to the low prevalence of this disease entity, there is limited knowledge and literature on the approach to diagnosing and treating these neoplasms, especially in the setting of the aforementioned comorbidities. Here, we describe two cases of this rare entity, presenting in two different circumstances: one in the setting of immunosuppression for IBD and arthritis, with a synchronous urothelial carcinoma, and the second appearing as the source of an acute abdomen. Both diagnoses were established following pathologic analysis.

References

Jun 14, 2002·Surgery Today·Hideto FujitaKishichiro Watanabe
Jan 28, 2010·The American Journal of Gastroenterology·Richard G ArmstrongTimothy R Card
Aug 25, 2012·Annals of Diagnostic Pathology·Gitika AggarwalJeffrey R Lee
Sep 12, 2013·Case Reports in Gastrointestinal Medicine·Haritha ChelimillaMasooma Niazi
Apr 30, 2014·International Journal of Colorectal Disease·P SinghK Umanskiy
Aug 21, 2014·The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society of Gastroenterology·Arzu YarenGamze Gököz Doğu
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Oct 22, 2015·Journal of Gastrointestinal Oncology·Walid FarajDeborah Mukherji
Oct 12, 2016·Internal Medicine·Daisuke AkutsuIchinosuke Hyodo

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Citations

Apr 8, 2020·Case Reports in Surgery·Amélie BeauchampHerawaty Sebajang
Dec 4, 2021·BMJ Case Reports·Crystal NguyenAbdul Qureshi

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Methods Mentioned

BETA
SMA
biopsy
surgical resection

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