Leiomyosarcoma Masquerading as Bowel Obstruction: A Rare and Lethal Entity

Document Type

Conference Proceeding

Publication Date

11-2025

Publication Title

American Journal of Clinical Pathology

Abstract

Introduction/Objective: Leiomyosarcoma (LMS) of the gastrointestinal tract (GIT) is an aggressive malignancy often presenting as bowel obstruction. Its vague symptoms and limited accessibility frequently delay diagnosis. Unlike gastrointestinal stromal tumors (GISTs), LMS lacks effective targeted therapy, making complete surgical resection the primary treatment option. Methods/Case Report: Case 1: An 89-year-old male presented with acute abdominal pain. CT imaging revealed a 9 × 5 cm exophytic mass causing small bowel obstruction. Laparotomy identified a large, well-circumscribed jejunal mass with bowel twisting and obstruction. Segmental small bowel resection was performed. Pathologic examination confirmed a LMS. Case 2: An 81-year-old male presented with acute abdominal pain. CT and laparotomy revealed a cecal mass with obstruction. The patient underwent right hemicolectomy. Pathologic examination showed a moderate to poorly differentiated LMS. Immunohistochemistry in both cases was positive for desmin and SMA, and negative for CD34, CD117, and S100, differentiating LMS from GIST. Although the postoperative course was uneventful, the first patient (case 1) succumbed six months later, emphasizing the aggressive nature of LMS. Results: NA Conclusion: Despite an uneventful postoperative course, the first patient succumbed six months later, highlighting LMS’s aggressive nature. These cases emphasize the diagnostic and therapeutic challenges of LMS, underscoring the need for heightened clinical aware - ness and multidisciplinary approaches for better patient outcomes.

Volume

164

Issue

Suppl 1

First Page

S47

Comments

American Society for Clinical Pathology (ASCP) Annual Meeting, November 17-20, 2025, Atlanta, GA

Last Page

S47

DOI

10.1093/ajcp/aqaf121.112

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