Case Report of a 10 cm Subdued Abdominal Mass: Diagnosis and Management of a Rare Primitive Mesenteric Leiomyosarcoma

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Carine EL-HAJJ
Clemence MATTA
Bachir ELIAS


Introduction: Specific management schemes of the exceedingly rare primitive mesenchymal leiomyosarcomas do not exist. Reporting their behavior and management is necessary to be able to construct evidence-based directives.

Case Report: We report a case of a 42-year-old Caucasian woman that presented with a large indolent abdominal mass evolving over 3 months. Two differential diagnosis were looked upon, either GIST or leiomyosarcoma. The abdomino-pelvic ct-scan proved that this tumor could be completely resected, so the patient was successfully operated within 2 weeks of the preliminary diagnosis. A monobloc negative margin resection was performed and the patient recovered on the surgical floor. The anatomopathological studies and immunohistochemistry tests confirmed the presence of a primitive mesenchymal leiomyosarcoma. The patient was recommended a follow up every 4 months with a thoraco-abdomino-pelvic ct-scan due to her economic status.

Conclusion: The management of rare tumors is always challenging due to the lack of knowledge concerning its behavior and response to the various treatment modalities. Reporting this rare case of mesenchymal leiomyosarcoma and similar cases will enable a better understanding of this disease and its treatment.

Leiomyosarcoma, mesenteric leiomyosarcoma, abdominal mass, surgical management.

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How to Cite
EL-HAJJ, C., MATTA, C., & ELIAS, B. (2020). Case Report of a 10 cm Subdued Abdominal Mass: Diagnosis and Management of a Rare Primitive Mesenteric Leiomyosarcoma. Journal of Advances in Medicine and Medical Research, 32(12), 98-103.
Case Report


Serrano C, George S. Leiomyosarcoma. Elsevier. 2018;27(2013):957-974.
DOI: 10.1016/j.hoc.2013.07.002

Kato T, Noda H, Abe IKU, Alonso S. Curative resection for leiomyosarcoma of the descending mesocolon with metachronous liver metastasis : A case report and literature review. 2016:53-56.
DOI: 10.3892/mco.2016.874

Poveda A, García X, López-guerrero JA, et al. GEIS guidelines for gastrointestinal sarcomas (GIST). 2017;55:107-119.
DOI: 10.1016/j.ctrv.2016.11.011

O’Donnell D. Problem Solving in Oncology; 2013.

Bastiaannet E, Groen H, Jager PL, et al. The value of FDG-PET in the detection, grading and response to therapy of soft tissue and bone sarcomas . A systematic Review and Meta-Analysis. 2004:83-101.
DOI: 10.1016/j.ctrv.2003.07.004

Macpherson RE, Pratap S, Tyrrell H, et al. Retrospective audit of 957 consecutive F FDG PET – CT scans compared to CT and MRI in 493 patients with different histological subtypes of bone and soft tissue sarcoma. Clin Sarcoma Res. 2018: 1-12.
DOI: 10.1186/s13569-018-0095-9

Ilias AS, Yaacob H, Zainira W, Zain W, Zakaria AD. Rare case of primary leiomyosarcoma of sigmoid mesocolon. 2017:1-5.

Dasgupta S, Chakrabarti S. Ileal Mesenteric leiomyosarcoma — Report of a rare neoplasm. 2016:114-117.
DOI: 10.1007/s12029-015-9725-0

Raut CP, Maki R. Local treatment for gastrointestinal stromal tumors, leiomyomas, and leiomyosarcomas of the gastrointestinal tract; 2018..
Available: treatment for gastrointestinal stromal tumors, leiomyomas, and leiomyosarcomas of the gastrointestinal&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

Magg T, Schober T, Walz C, Ley-zaporozhan J, Hauck F. Epstein–Barr Virus+ smooth muscle tumors as manifestation of primary immunodeficiency disorders. 2018;9:1-7.
DOI: 10.3389/fimmu.2018.00368

Bharti JN, Dey B, Desai P, Gupta R, Khurana N, Gandhi G. Primary leiomyosarcoma of peritoneal cavity. Rare Tumors. 2014;6:1-2.
DOI: 10.4081/rt.2014.5165

Dalal V. Primary Leiomyosarcoma of the mesentery : A case report. IJMS. 2017; 42(5).

Murez T, Savoie P, Fléchon A, et al. Recommandations franc ¸aises du comite de cancerologie de l’AFU — Actualisation 2018—2020 : sarcomes rétropéritonéaux. Prog en Urol. 2018;28(12):165-174.
DOI: 10.1016/j.purol.2018.08.010