Small bowel sarcoma: A rare case report

Abstract

Sarcoma of the small bowel is an extremely rare type of small bowel malignancy and represents around 10 per cent of small bowel cancers. Usually asymptomatic, patients can present with chronic abdominal distention with pain and/or weight loss. Most pathologists now refer to small bowel sarcomas (SBS) as gastrointestinal stromal tumours as they are mesenchymal neoplasms believed to be derived from the interstitial cells of Cajal in the gastrointestinal tract. SBS can be highly vascular and commonly ulcerate and/or bleed. They tend to be aggressive and have a poor prognosis. Surgery is the treatment of choice for SBS, with definitive diagnosis usually made postoperatively with the aid of histopathology. We would like to highlight the importance of careful intra-operative examination of an unknown small bowel (SB) mass, which can give the surgeon clues to the type of tumour present. This case report aims to demonstrate this important process: recognising SBS intra-operatively will aid the surgeon with performing the appropriate resection as minute omental metastasis can be present with SBS; in such cases an omentectomy during the laparotomy is recommended. In institutions where available, intra-operative radiotherapy is ideal.

Small Bowel Neoplasms: A Pictorial Review

“…Sarcoma accounts for about 10% of small bowel cancers (88). Leiomyosarcoma is the most common sarcoma occurring in the small bowel.…”

“…Patients can present with bleeding or perforation. Treatment includes surgical removal and radiation therapy (88).…”

Gastrointestinal Tract Microbiome Effect and Role in Disease Development

“…In 66% of cases with small bowel sarcomas, a palpable abdominal mass is formed. These sarcomas are usually aggressive, and patients have a poor prognosis [ 53 ].…”