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Case Reports
. 2021 Nov 18;9(1):1-4.
doi: 10.1159/000520802. eCollection 2022 Mar.

Lower Extremity Varicose Veins: An Unusual Presentation of Small Bowel Leiomyosarcoma

Karim Abou El Joud  1 , Misha Abbasi  1
Affiliations
Case Reports

Lower Extremity Varicose Veins: An Unusual Presentation of Small Bowel Leiomyosarcoma

Karim Abou El Joud et al. Gastrointest Tumors. .

Abstract

Leiomyosarcomas (LMSs) are extremely rare and comprise only 1.2% of small bowel malignancies. Advancements in immunohistochemical techniques have allowed for the differentiation between LMSs and gastrointestinal stromal tumors. LMSs remain difficult to detect via endoscopy and require a more intricate diagnostic approach. The staging and sizing of these tumors are important prognostic indicators. We report a case of a 67-year-old male who presented with bulging lower extremity veins, abdominal bloating, and weight loss. A CT of the abdomen and pelvis revealed a pelvic mass arising from the small bowel and a metastatic hepatic lesion, which was found to be compressing the inferior vena cava. A biopsy of the hepatic lesion confirmed the diagnosis of metastatic LMS.

Keywords: Gastrointestinal stromal tumor; Leiomyosarcoma; Small intestine; Stromal tumors.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Coronal CT post-contrast images showing a 12-cm heterogenous and lobulated pelvic mass, arising from the small bowel. Several hepatic masses, with a 4-cm lesion projecting from the dome of the liver and compressing the inferior vena cava.
Fig. 2
Fig. 2
Axial CT post-contrast images showing a 12-cm heterogenous and lobulated pelvic mass, arising from the small bowel. Several hepatic masses, with a 4-cm lesion projecting from the dome of the liver and compressing the inferior vena cava.
Fig. 3
Fig. 3
Mitotically active spindle-shaped cells with moderate atypia and abundant eosinophilic cytoplasm.
Fig. 4
Fig. 4
Mitotically active spindle-shaped cells with moderate atypia and abundant eosinophilic cytoplasm.
Fig. 5
Fig. 5
Immunohistochemical staining positive for desmin.
See this image and copyright information in PMC

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