Giant Extraluminal Leiomyoma of the Colon: Rare Cause of Symptomatic Pelvic Mass

Sagnotta, Andrea; Sparagna, Alessandra; Uccini, Stefania; Mercantini, Paolo

doi:10.9738/intsurg-d-14-00054.1

Cited by 15 publications

(19 citation statements)

References 8 publications

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“…Colonic leiomyomas or colonic smooth muscle tumors are rare gastrointestinal tumors frequently found around the sigmoid and transverse colon [1]. They can be found in individuals of all ages with an increase in frequency after the age of 60 years [5]. Smooth muscle colonic tumors are often benign; however, some may be locally aggressive or even highly malignant [1].…”

Section: Discussionmentioning

confidence: 99%

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Sigmoid Leiomyoma: An Uncommon Occurrence

Forlemu

Chuang

2020

Cureus

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Leiomyomas in the colon are uncommon accounting for a few cases of gastrointestinal smooth muscle tumors. These tumors are usually benign and asymptomatic. They may present with abdominal pain, intestinal obstruction, perforation, and rarely hemorrhagic, especially when the tumor is large. We present the case of a sigmoid leiomyoma in a 60-year-old patient consulting for a positive fecal occult blood test. Colonic leiomyomas should be considered in the differential diagnosis when a polyp is found during routine endoscopic evaluations. This case also highlights the limitations of diagnosing the nature of polyps using endoscopy alone.

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Section: Discussionmentioning

confidence: 99%

“…Complete endoscopic removal of these tumors is difficult because of their submucosal origin. They are however benign tumors with an excellent prognosis and do not recur after removal [4]. We present a case of a 10-mm sessile sigmoid colon polyp that was resected and later found to be a leiomyoma on histology.…”

Section: Introductionmentioning

confidence: 97%

Sigmoid Leiomyoma: An Uncommon Occurrence

Forlemu

Chuang

2020

Cureus

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“…Miettinen et al summarized 88 colorectal leiomyomas and noted that endoscopic snare polypectomy resulted in complete tumor removal in virtually all cases [ 8 ]. The overall prognosis is reportedly good, and no recurrence has been documented in literature [ 15 ]. Thus, endoscopic resection is a treatment of choice for leiomyomas arising from the muscularis mucosa of the colon.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Leiomyoma in the Colon Masquerading as Other Types of Colonic Pedunculated Polyps

Ikeda

Iwamuro

Tanaka

et al. 2018

Case Reports in Gastrointestinal Medicine

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We describe two cases of leiomyoma in the colon that were diagnosed histologically after endoscopic resection. The first case was a 79-year-old Japanese woman who presented with a pedunculated polyp of 14 mm length at the splenic flexure. Preoperative diagnosis suggested a colonic mucosubmucosal elongated polyp. The second case was a 29-year-old Japanese woman who presented with a pedunculated polyp of 40 mm length at the hepatic flexure and had an ulcer on top of the polyp. Preoperative diagnosis suggested an inflammatory fibroid polyp. A pathological diagnosis of colonic leiomyoma was made after endoscopic resection in both cases. Both tumors were confirmed to originate, not from the proper muscle layer, but from the muscularis mucosae. These cases underscore that although colonic involvement is infrequent, leiomyomas can display pedunculated morphology in the colon rather than the typical gross appearance of gastrointestinal submucosal tumors seen with sessile morphology.

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“…On CECT, a heterogeneous mass lesion with areas of calcification and focal necrosis may be seen. Therefore, accurate diagnosis requires a combination of endoscopy and imaging modalities, such as CECT, magnetic resonance imaging, or endoscopic ultrasonography [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

An Uncommon Presentation of Leiomyoma Cecum as a Subcutaneous Abscess of the Right Flank

Kandhasamy¹,

Sangwan²,

Sahoo³

et al. 2018

Cureus

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Cecal leiomyomas are rare benign tumors of smooth muscle arising from the colonic muscularis mucosa or muscularis propria. They are usually asymptomatic in nature and, if symptomatic, may present as pain in the abdomen, intestinal obstruction, or bleeding. In some cases, leiomyoma can cause free perforation leading to peritonitis. Contrast-enhanced computed tomography (CECT) and colonoscopy were the diagnostic modalities used for evaluation. It is extremely unusual for a benign lesion of the cecum to present as a ruptured subcutaneous abscess. A 40-year-old man presented to the surgical emergency with complaints of right loin swelling and dull aching pain for one week. The patient did not have any significant medical history. Examination revealed a 5×5 cm swelling in the right anterior lumbar region. Blood investigations revealed anemia with leukocytosis. An abdominal CECT revealed a 9×6 cm heterogeneous enhancing mass lesion arising from the cecum with hypodense areas abutting the anterior abdominal wall and tracking into the intermuscular plane. The patient underwent surgical exploration, and a 9×6 cm growth arising from the cecum with a localized abscess tracking into the intermuscular plane in the right anterior abdominal wall and forming a subcutaneous abscess was intraoperatively found. A right hemicolectomy with ileocolic anastomosis was done, with external drainage of the subcutaneous abscess. Histopathological examination of the resected specimen revealed a leiomyoma of the cecum with abscess. To the best of our knowledge, this is the first report of a case of cecal leiomyoma to rupture into the subcutaneous space and present as a flank abscess.

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Giant Extraluminal Leiomyoma of the Colon: Rare Cause of Symptomatic Pelvic Mass

Cited by 15 publications

References 8 publications

Sigmoid Leiomyoma: An Uncommon Occurrence

Sigmoid Leiomyoma: An Uncommon Occurrence

Two Cases of Leiomyoma in the Colon Masquerading as Other Types of Colonic Pedunculated Polyps

An Uncommon Presentation of Leiomyoma Cecum as a Subcutaneous Abscess of the Right Flank

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