A CASE OF LEIOMYOSARCOMA OF THE ILEUM PRESENTING WITH PERFORATED PERITONITIS

A rare case of leiomyosarcoma of the ileum presenting with perforated peritonitis is reported together with a review of the literature. In a 41-year-old woman first visited with the complaint of abdominal pain which started on the day before, an intensive pain centered around the right lower abdomen, muscular defense, and Blumberg sign were noted. Moreover, WBC was 12, 600/mm3 and abdominal series revealed a free air. the patient, accordingly, was diagnosed to have peritonitis due to acute appendicitis with perforation, and underwent emergency operation. On laparotomy extraluminal growing type of tumor which formed a lump was found approximately 150cm to oral-side from the ileocecal valve, which caused perforated peritonitis. Ileectomy ranging approximately 100cm was carried out. Histologically it was leiomyosarcoma grown extraluminally arising from the proper mucle layer, and had mitotic figures in high frequency. In Japan perforation of leiomyosarcoma of the small intestine is extremely rare that only 24 operative cases have been reported.