小腸平滑筋肉腫により穿孔性腹膜炎を呈した１例

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  • Perforative peritonitis due to leiomyosarcoma of the small intestine.

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We report a rare case of perforated leiomyosarcoma of the small intestine in a 79-year-old woman who was admitted with acute abdominal pain on October 12, 1990. Physical examination revealed signs of panperitonitis, and emergency exploratory laparotomy was performed. At laparotomy, a mass 4cm in diameter was detected approximately 150cm anal side from Treitz ligament. The tumor and adjacent intestine (25cm) were resected. Histologically, the tumor was diagnosed as leiomyosarcoma arising from the proper muscle layer. The postoperative course was uneventful, and the patient is asymptomatic and free of detectable lesion one year after resection. We also review 47 cases of perforation of leiomyosarcoma of the small intestine reported in Japan. Most tumors were detected during the sixth, seventh or eighth decade of life, and the duration of symptoms in most patients was short, i.e., within 10 days. More than 70% of leiomyosarcomas of the jejunum were located within 50cm from Treitz ligament. The cumulative 5-year survival rate of patients with perforated leiomyosarcoma was 46.0%.

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