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Case Reports
. 2024 Aug:121:110010.
doi: 10.1016/j.ijscr.2024.110010. Epub 2024 Jul 6.

Rare case of giant ischiorectal leiomyosarcoma

Kalkidan Kibret Mekoya  1 , Sherefa Hussein Sula  2 , Kaleab Habtemichael Gebreselassie  3 , Kalid Sherefa Reshid  2
Affiliations
Case Reports

Rare case of giant ischiorectal leiomyosarcoma

Kalkidan Kibret Mekoya et al. Int J Surg Case Rep. 2024 Aug.

Abstract

Introduction: Leiomyosarcoma is a rare type of soft tissue sarcoma especially giant ones (size >5 cm). It is usually arises from the uterus and retroperitoneum. Ischiorectal space is not a common site for primary leomyosarcoma. There are only few case reports about Ischiorectal leiomyosarcoma.

Presentation of case: We present a case of 25 yrs. old female patient, who presented with a swelling on left buttock. It measures 9 by 9.5 by 18 cm on MRI. Complete tumor excision done and immunohistochemistry tests confirmed the diagnosis of leiomyosarcoma.

Discussion: Due to its rarity, unusual site and large size leiomyosarcoma poses a great challenge for a surgeon both to diagnose and manage it. Early diagnosis and management improves prognosis and decreases recurrence rate because sarcomas have high recurrence rate. It is highly recommended to have multidisciplinary approach.

Conclusion: The case report highlights on both diagnostic and therapeutic challenges associated with giant leiomyosarcoma. There are no strict guidelines to follow when managing this type of cases but rather approach has to be individualized. Since there are only few case reports on this specific pathology we advocate for surgeons to share their experience on similar cases.

Keywords: Gaint leiomyosarcoma; Ischiorectal space; Leiomyosarcoma.

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Conflict of interest statement

Conflict of interest statement The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
A, Axial T2 FRFSE image showing a hyperintense lobulated ischiorectal mass with internal septations pushing the rectum (red arrow) to the right. A clear fat plane is seen between the mass and the rectal wall. Urinary bladder is indicated with yellow arrow Distal extent of the mass is visible on Panel B at the level of perineal body. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 2
Fig. 2
A, Preoperative picture of the mass bulging through the perineum. Transurethral catheter is in place. B, Intraoperative picture of the lobulated ischiorectal mass fully dissected out through a perineal incision.
Fig. 3
Fig. 3
A T2 sagittal image of preoperative MRI image pushing uterus (red arrow) and bladder (yellow arrow) upward and extending down to the perineum. B, T2 sagittal reconstructed image of the postoperative MRI image showing pelvic organs in their proper anatomic orientation. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
See this image and copyright information in PMC

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