Primary leiomyosarcoma of the greater omentum: a case report

Abstract

Introduction: Greater omentum leiomyosarcomas are rare tumors with only a few cases reported in literature.

Presentation of case: We report the case of a 68-year-old man who consulted complaining of diffuse abdominal pain without a palpable mass at physical examination. Imaging studies revealed a solid-cystic lesion in the right lower quadrant. Surgical resection was performed and the tumor was diagnosed as a leiomyoscarcoma by histological and immunohistochemical examinations.

Discussion: Surgical resection of all lesions seems to be a reasonable therapeutic approach if resection is feasible. Chemotherapy may be used in selected cases.

Conclusion: More cases are needed to define the best treatment approach of this disease.

Keywords: Case report; Greater omentum; Leiomyosarcoma; Primary tumor.

Fig. 1

Transverse (A) and coronal (B) sections of a T2-weighted magnetic resonance imaging showing a solid-cystic mass in the right lower quadrant originating from de greater omentum.

Fig. 2

Multiloculated tumor with solid and cystic component and hemorrhagic areas, partially surrounded by adipose tissue (A). Ovoid cells with vesicular nucleus and eosinophilic cytoplasm showing numerous mitosis (H&E, ×40) (B). Moderately cellular area with fusiform cells arranged in a reticular pattern in fibromixoid stroma (H&E, ×4) (C). Immunohistochemistry study showing fusiform cells positive for H-caldesmon (×10) (D). Tumor cells positive for Actin (×10) (E).