Acute Jejunal Leiomyosarcoma: A Rare Case Study

Abstract

The objective of this study is to describe a particular case example of small bowel leiomyosarcoma, which is characterized by an acute abdomen and signs and symptoms of intestinal obstruction. Sarcoma accounts for 1.2% of gastrointestinal malignancies. It can present as an asymptomatic mass or with constitutional symptoms like GI upset, melena, weight loss, fatigue, and rarely intussusception and bowel obstruction. Early diagnosis is difficult due to unspecified symptoms and the slow growth of the tumor. Surgical resection is still the preferred therapy. The case report was based on a 31-year-old gentleman hospitalized in the Emergency with severe abdominal aches, discomfort and nausea for 4 days. The patient had a significant unintentional weight loss for 1 month. A physical examination revealed epigastric and periumbilical tenderness. An immediate abdominal X-ray revealed several air-fluid levels, which indicate a minor intestinal obstruction in the core of the abdomen. A subsequent CT scan further noted an ileoileal intussusception with intestinal obstruction. The decision was taken to proceed with a crucial exploratory laparotomy, which reported a 4x5 cm tumor in the jejunum with several enlarged mesenteric lymph nodes. The histopathology report showed a high-grade leiomyosarcoma with confirmatory immunological staining.