Abstract
A surgical case of leiomyosarcoma arising from the ascending colon, presenting as acute suppurative peritonitis, is herein described. A 70-year-old woman complaining of lower abdominal pain presented to our clinic on October 12, 1994. She was admitted with a tentative diagnosis of peritonitis. At emergency laparatomy, purulent intraabdominal fluid was present, and a fist-sized mass was seen in the ascending colon just proximal to the hepatic flexure. A right hemicolectomy was thus performed based on a diagnosis of perforating colon cancer. The histologic findings were consistent with leiomyosarcoma with abscess formation in and around the tumor. Five mitotic figures per field were observed at 10x magnification. Immunohistochemical studies revealed immunoreactivity for α-smooth muscle antigen (α-SMA), vimentin, and desmin. After reviewing the clinicopathologic characteristics of colon leiomyosarcoma as described in 78 Japanese cases and 70 cases from the foreign literature, we thus propose that colon leiomyosarcoma frequently arises from the transverse colon. In addition, our case also represents the only reported case in Japan in which an adult patient underwent a successful operation for perforated leiomyosarcoma of the colon.
Similar content being viewed by others
References
Scott CR (1923) Myoma malignum particularly other than uterine Northwest Med 23:436–439
Suzuki A, Fukuda S, Tomita S, Aizawa T, Munakata A, Yoshida Y, Kamada Y (1984) An unusual case of colonic leiomyosarcoma presenting with fever-significant uptake of radioactivity of gallium-67 in the tumor. Gastroenterol Jpn 19:487–492
Ohta K, Sakamoto S (1957) Leiomyosarcoma of the intestine (in Japanese). Gann No Rinsho (Jpn J Cancer Clin) 3:521–531
Obata H, Inoue K, Katoh O, Nakamura K (1963) A case of leiomyosarcoma arising in the transverse colon (in Japanese). Geka (Surgery) 25:1427–1430
Gann Kenkyukai (1969) A case of leiomyosarcoma of the descending colon (in Japanese). In: Gann Kenkyukai (eds) Gann No Kenkyu. Doubun Syoin, Tokyo, pp 249–250
Minami S, Nishikawa M, Kuroda K, Yamamoto T, Ichihara S, Sugihara T, Mikami Y (1972) A case of leiomyosarcoma arising in the ascending colon (in Japanese). Shimane Igaku 4:912–918
Kodaira S, Higasiizumi T (1973) Three cases of leiomyosarcoma in colon and rectum, and review and clinicopathological study of Japanese literature (in Japanese). Nippon Daichou Koumonbyou Gakkai Zasshi (J Jpn Soc Colo-proctol) 26:12–20
Yamakawa T, Hasebe M (1975) Leiomyosarcoma of the transverse colon. Gastroenterol Jpn 10:77–79
Okada K, Nakao N, Inamoto K, Sugawara T, Sugiki K, Nishiura N, Shimada K, Uchide H, Sato K, Yoshimoto S (1975) A case of leiomyosarcoma of rectosigmoid colon diagnosed by arterial angiography (in Japanese). Rinsho Houshasen (Jpn J Clin Radiol) 20:1183–1188
Takeuchi T, Yamamoto K, Sugawara Y, Utsumi M, Ohara M, Fukuhara K (1976) A case report of leiomyosarcoma of the ascending colon (in Japanese with English abstract). Ohara Nennpou (Ann Rep Ohara General) 19:35–39
Nojiri K, Takeda S, Kouriyama E, Shibata J, Hayashi Y, Yamada T, Sato H, Katagiri H, Nakajima H (1978) Leiomyosarcoma of the sigmoid colon. — Report of a case (in Japanese). Asahikawa Shi Byou Shi (J Asahikawa Municipal) 11:27–30
Nakano Y, Koyama R, Katsusida T, Kadono Y, Maruyama H, Takeuchi S, Mochizuki Y (1979) A case of leiomyosarcoma of ascending colon (in Japanese). Gann No Rinsho (Jpn J Cancer Clin) 25:137–142
Sato M, Tani M, Narisawa T, Takahashi T, Arakawa H (1979) Two cases of colonic leiomyosarcoma (in Japanese). Akita Ishi Kaishi (Akita Med J) 31:144–146
Morioka M, Uehata Y, Koyama M, Sakurada Y, Shiraishi T, Miyasaka M, Suzuki K, Nojima T, Fujioka Y (1980) An autopsy case of leiomyosarcoma in descending colon (in Japanese). Gann No Rinsho (Jpn J Cancer Clin) 26:301–305
Yamauchi M, Furukawa R, Fukuda Y (1980) Two cases of colon leiomyosarcoma (in Japanese). Geka Shinryo 22:617–620
Machida T, Yoshida K, Ikeuchi H, Kano K, Takahashi M, Miura Y, Asai T (1980) A case of leiomyosarcoma of transverse colon — Particular reference to relationship of histology to prognosis (in Japanese). Nippon Shoukaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 13:1389–1392
Hanai T, Suzuki Y, Hato S, Aiba K, Hananouchi M, Hayashi K (1982) A case of perforated leiomyosarcoma in the transverse colon (in Japanese). Nippon Rinsho Geka Igakukai Zasshi (J Jpn Soc Clin Surg) 44:733–737
Shimano Y, Shinomiya Y, Noka F, Inatugi N, Shiratori T, Sugihara S (1982) A case of leiomyosarcoma of the transverse colon (in Japanese). Geka Shinryo 47:369–374
Hatsuse K, Takemura K, Kurokawa T, Tamaki K, Kabe S, Mizoguchi O, Hirade H, Terashima H, Mimura K, Iwasa H, Takatani O (1982) A case of small leiomyosarcoma of the colon: Review of 22 cases reported in Japan (in Japanese). Shokaki Geka (Gastroenterol Surg) 5:623–626
Ono K, Sato Y, Otsuka K, Furutani S, Okuma N, Kuma K, Kunitomo T (1984) A case of leiomyosarcoma in the cecum (in Japanese). Geka (Surgery) 46:205–210
Miyoshi T, Yamakawa K, Hirosawa K, Itoh S, Katoh K, lizumi S, Kawabata K (1984) A case of primary leiomyosarcoma at the sigmoid colon and jejunum (in Japanese with English abstract). Nippon Daichou Koumonbyou Gakkai Zasshi (J Jpn Soc Coloproctol) 37:138–144
Kano N, Matsubara N, Saiga T, Ikeda M, Sakai S, Honma M, Koyama A, Fukuda M, Koyama N, Sakamoto A (1985) A case of double leiomyosarcomas in the colon (in Japanese). Geka Shinryo 53:582–585
Tamagawa Y, Yasui Y, Hattori S, Matsunaga M, Kishida T, Ohsawa T, Yoshida Y, Hirakawa T, Kobayashi M, Tuneoka K, Tashiro S, Shirota A, Yamanaka N (1985) A case of leiomyosarcoma of the descending colon (in Japanese with English abstract). Yakuri to Chiryou (Jpn Pharmacol Ther) 13:85–91
Watanabe H, Oshiro H, Yamamoto T, Tanaka I, Yahata H, Matsuda M, Hamasaki S, Hoshino T, Sadamoto S, Hosoma S (1986) Four cases of sarcoma of the large intestine (in Japanese). Hiroshima Igaku (J Hiroshima Med Assoc) 39:1386–1390
Ikeguchi M, Kaneko T, Tamura H, Murakami T, Masaki T, Taniguchi H, Maeda K (1987) A case of synchronous multiple leiomyosarcoma of the colon and jejunum (in Japanese). Geka (Surgery) 49:191–194
Tomoda H, Jinushi K, Nakane H, Furusawa M, Okumura Y, Kiyonari H, Hayashi I (1988) Leiomyosarcoma in the large bowel (in Japanese). Geka (Surgery) 50:628–630
Ozaki Y, Maeda K, Kudoh H, Murakami S, Ihaya T (1988) A case of leiomyosarcoma of the descending colon (in Japanese). Geka (Surgery) 50:709–712
Nagaya M, Tsuda M, Ishiguro Y (1989) Leiomyosarcoma of the transverse colon in a neonate: A rare cause of meconium peritonitis. J Pediatr Surg 24:1177–1180
Toda J, Haga S, Kumazawa K, Umeda H, Mori M, Nakajima H, Oishi T, Imamura H, Yagawa H, Kikuchi K, Kajiwara T (1989) A case of multiple leiomyosarcoma of the colon presenting with intraperitoneal hemorrhage (in Japanese with English abstract). Nippon Daichou Koumonbyou Gakkai Zasshi (J Jpn Soc Coloproctol) 42:112–117
Miura Y, Kato Y, Kiyomitsu R, Ogawa Y, Okamoto T, Koide K, Noriyuki T, Fujikawa K, Yamane K, Iwamoto T (1991) A case of large leiomyosarcoma in the transverse colon (in Japanese with English abstract). Nippon Rinshou Geka Gakkai Zasshi (J Jpn Soc Clin Surg) 52:837–843
Abe K, Horita S, Hirai S, Oka Y, Mochiji M, Nakajima K, Takahashi A, Kamoshida T (1992) A case of leiomyosarcoma of the descending colon (in Japanese). Hitachi Ishi (Hitachi Med J) 30:46–50
Ochiai T, Shimoda K, Suzuki T, Yoshii K, Shigematsu K, Moriwaki M, Kinoshita U, Okano T (1992) A case of leiomyosarcoma of the sigmoid colon (in Japanese with English abstract). Nippon Daichou Koumonbyou Gakkai Zasshi (J Jpn Soc Coloproctol) 45:316–320
Ikeda S, Sera Y, Yamamoto H, Yamashita S, Nagase H, Ogawa M (1993) Leiomyosarcoma of the colon in a newborn: A case report and review of the literature. Arch Jpn Chir 62:166–171
Sako T, Matsumoto S, Ikuta H, Naitoh S, Kurogoh F (1993) A case of leiomyosarcoma of the transverse colon (in Japanese with English abstract). Nippon Daichou Koumonbyou Gakkai Zasshi (J Jpn Soc Coloproctol) 46:269–272
Friesen R, Moyana TN, Murray RB, Murphy F, Inglis FG (1992) Colorectal leiomyomas: a pathobiologic study with long-term follow up. Can J Surg 35:505–508
Kamohara Y, Waki S, Uchimura M, Kida H, Kanda K, Narita K, Maeda S, Soejima H, Miyasato H (1992) A case of colonystimulating factor-producing leiomyosarcoma of the ileum (in Japanese with English abstract). Nippon Rinshou Geka Gakkai Zasshi (J Jpn Soc Clin Surg) 53:381–385
Cox PH, Verweij J, Pillay M, Stoter G, Schonfeld D (1988) Indium 111 antimyosin for the detection of leiomyosarcoma and rhabdomyosarcoma. Eur J Nucl Med 14:50–52
Keane PF, Farmer I, Crosbie R, Arnold A (1986) Leiomyosarcoma of the colon and rectum. Irish Med J 79:190
Nuessle WR, Magill TR (1990) Leiomyosarcoma of the transverse colon, report of a case with discrssion. Dis Colon Rectum 33:323–326
Zorning C, Thoma G, Schroder S (1990) Diffuse leiomyosarcomatosis of the colon. Cancer 65:570–572
Fridie IL, Hong IS, Green WR (1992) Multicentric gastrointestinal and extra-intestinal leiomyosarcomatosis: A case report. J Natl Med Assoc 84:629–631
MacKenzie DA, McDonald JR, Waugh JM (1954) Leiomyoma and leiomyosarcoma of the colon. Ann Surg 139:67–75
Levine S, Kiehl PV, Serfas CL (1965) Leiomyosarcoma of the colon. Am J Surg 109:816–818
Warkel RL, Stewart JB, Temple AJ (1975) Leiomyosarcoma of the colon: report of a case and analysis of the relationship of histology to prognosis. Dis Colon Rectum 18:501–506
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Iwasa, K., Taniguchi, K., Noguchi, M. et al. Leiomyosarcoma of the colon presenting as acute suppurative peritonitis. Surg Today 27, 337–344 (1997). https://doi.org/10.1007/BF00941809
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00941809