Primary leiomyosarcoma of the colon transversum mimicking a periappendiceal abscess: a case report and review of the literature

Czech version

Authors: J. Knap ^1,2
Authors‘ workplace: Chirurgické oddělení, Nemocnice Vyškov, p. o. ¹; II. interní klinika – gastroenterologická a geriatrická LF UP a FN Olomouc ²
Published in: Gastroent Hepatol 2025; 79(3): 197-201
Category: Case Report
doi: https://doi.org/10.48095/ccgh2025197

Overview

Leiomyosarcoma (LMS) of the gastrointestinal tract, and particularly primary LMS of the colon, is an extremely rare and highly aggressive malignancy with a poor prognosis. The five-year survival rate is approximately 50% for localized disease. It does not exceed 10% in cases of metastatic disease. Its manifestations can vary, ranging from acute symptoms such as bleeding or intussusception to more prolonged presentations. Due to its rarity and absence of specific markers, preoperative diagnosis is virtually impossible. This report presents the case of a 67-year-old female patient admitted to our facility with a clinical representation suggestive of a periappendiceal infiltrate/abscess, which was ultimately revealed to be a primary LMS of the dolichotransverse colon located in the right lower abdomen. Following endoscopic diagnostic resection, surgical treatment with curative intent was performed, as no dissemination of the disease was detected preoperatively.

Keywords:

leiomyosarcoma – colonoscopy – colon cancer

Sources

1. Yahagi M, Ishii Y, Hara A et al. Laparoscopic surgery to treat leiomyosarcomas of the sigmoid colon: a case report and literature review. Surg Case Rep 2019; 5 (1): 20. doi: 10.1186/s40792-019-0579-8.

2. Aichouni N, Ziani H, Karich N et al. Primary leiomyosarcoma of the sigmoid colon: case report and review of literature. Radiol Case Rep 2021; 17 (1): 35–40. doi: 10.1016/j.radcr.2021.09.061.

3. Crystal JS, Korderas K, Schwartzberg D et al. Primary leiomyosarcoma of the colon: a report of two cases, review of the literature, and association with immunosuppression for IBD and rheumatoid arthritis. Case Rep Surg 2018; 2018: 6824643. doi: 10.1155/2018/6824643.

4. Yamamoto H, Handa M, Tobo T et al. Clinicopathological features of primary leiomyosarcoma of the gastrointestinal tract following recognition of gastrointestinal stromal tumours. Histopathology 2013; 63 (2): 194–207. doi: 10.1111/his.12159.

5. Mackenzie DA, McDonald JR, Waugh JM. Leiomyoma and leiomyosarcoma of the colon. Ann Surg 1954; 139 (1): 67–75. doi: 10.1097/00000658-195401000-00008.

6. Omameuda T, Koizumi M, Miyahara Y et al. A rare case of leiomyosarcoma with a pleomorphic component of the sigmoid colon. J Surg Case Rep 2024; 2024 (7): rjae454. doi: 10.1093/jscr/rjae454.

7. Fickenscher M, Gvozdenovic N, Ponsel O. Diag- nostic and therapy of an early-stage primary leiomyosarcoma of the sigmoid colon: a case report. Clin Case Rep 2024; 12 (7): e9178. doi: 10.1002/ccr3.9178.

8. Doan TT, Pham DT. Primary leiomyosarcoma of the colon: a report of two cases and review of literature. Ann Med Surg 2024; 86 (8): 4865–4869. doi: 10.1097/MS9.000000000000 2277.

9. Falt P, Cyrany J, Kunovský L et al. Doporučené postupy České gastroenterologické společnosti ČLS JEP pro diagnostickou a terapeutickou koloskopii – aktualizované vydání 2024. Gastroenterol Hepatol 2024; 78 (3): 197–235. doi: 10.48095/ccgh2024197.

10. Krška Z, Hoskovec D, Petruželka L. Chirurgická onkologie. Praha: Grada Publishing 2014.

11. Lischke R, Tomáš T, Kopečková K et al. Sarkomy měkkých tkání – diagnostika a léčba. 2021 [online]. Dostupné z: https: //kdp.uzis.cz/res/guideline/14-sarkomy-mekkych-tkani-diagnostika-lecba-final.pdf.

12. Wang Y, Wang H, Yuan ZL et al. A pooled analysis of risk factors of surgically treated leiomyosarcoma of the colon in adults. World J Surg Oncol 2020; 18 (1): 61. doi: 10.1186/s12957- 020-01838-3.

13. Bananzadeh A, Mokhtari M, Sohooli M et al. Two cases of primary leiomyosarcoma of sigmoid colon treated with laparoscopic surgery: a case report and a review of literature. Int J Surg Case Rep 2021; 87: 106420. doi: 10.1016/j.ijscr.2021.106420.

14. Massaras D, Kontis E, Stamatis K et al. Primary leiomyosarcoma of the colon with synchronous liver metastasis. Rare Tumors 2022; 14: 20363613221080549. doi: 10.1177/203636 13221080549.

15. Hirota S, Isozaki K, Moriyama Y et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 1998; 279 (5350): 577–580. doi: 10.1126/science. 279.5350.577.

16. Nguyen C, Athigaman M, Qureshi A. Giant leiomyosarcoma of the transverse colon. BMJ Case Rep 2021; 14 (12): e246646. doi: 10.1136/bcr-2021-246646.

Doručeno/Submitted: 25. 4. 2025

Přijato/Accepted: 18. 5. 2025

Korespondenční autor

MUDr. Jan Knap

Chirurgické oddělení

Nemocnice Vyškov, p. o.

Purkyňova 235/36

682 01 Vyškov

knap@nemvy.cz