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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2000, Number 3

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An Med Asoc Med Hosp ABC 2000; 45 (3)

Colorectal leiomyosarcoma. Report of two cases

Piliado PHJ, Charua GL, Avendaño EO, Montes VJL

Language: Spanish
References: 17
Page: 140-144
PDF size: 326.85 Kb.


ABSTRACT

Almost all colorectal sarcomas are leiomyosarcomas that arise from smooth muscle cells of the intestinal wall. Presenting symptoms and endoscopic findings may be nonspecific and require surgical exploration for diagnosis. Complete resection is possible in 50 to 60 percent of the cases. Metastases to the peritoneal cavity and liver are common. Only 10 to 20 percent of completely resected patients may be considered cured. Patients with low-grade tumors live significantly longer than those with high grade tumors. Despite disappointing cure rates, radical resection provides good palliation. Neither radiation therapy nor chemotherapy have any proven efficacy as adjuvant therapies. The roles of sphincter-saving resection and local excision for rectal sarcoma are unclear. Conventional treatment of the lesions in the rectum has been abdominoperineal resection. Segmental resection remains indicated in the colonic tumors. Local excision has a rational basis given by the low incidence of lymph node involvement in colorectal sarcomas, but most of the existing data suggest that recurrence rates after local excision of rectal sarcomas are high. We present two cases both male patients, treated at coloproctologic unit at the Hospital General de Mexico. They had history of rectal bleeding, weight loss and positive immunohistochemical examination, with final diagnosis of leiomyosarcoma. Abdominoperineal resection for rectal leiomyosarcoma and sigmoidectomy for sigmoid leiomyosarcoma were the surgical treatments.


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