eP341 - Leiomyosarcoma of the Colon: A Case Study

ePoster Presenter(s)

• 

  Natalie Cuevas, MD

  PGY I
  Novant Health New Hanover Regional Medical Center
  Novant Health New Hanover Regional Medical Center
  Winnabow, NC, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• HL

  Hanah Lee, MPH, MD

  General Surgery Resident
  Novant Health New Hanover Regional Medical Center
  Wilmington, North Carolina, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• YR

  Yvette Rodriguez, MD

  PGY III
  Novant Health New Hanover Regional Medical Center
  Wilmington, North Carolina, United States

  Disclosure information not submitted.
• SF

  Sarah S. Fox, MD

  Division of Colon and Rectal Surgery
  Novant Health New Hanover Regional Medical Center
  Wilmington, North Carolina, United States

  Disclosure information not submitted.
• JP

  Joseph Payne, MD

  Division of Colon and Rectal Surgery
  Novant Health New Hanover Regional Medical Center
  Wilmington, North Carolina, United States

  Disclosure information not submitted.

Senior Author(s)

• WS

  Whiyie A. Sang, MD

  Division of Colon and Rectal Surgery
  Novant Health New Hanover Regional Medical Center
  Wilmington, North Carolina, United States

  Disclosure information not submitted.

Purpose/Background: Gastrointestinal stromal tumors (GIST) account for < 1% of all gastrointestinal malignancies while leiomyosarcoma accounts for < 0.1% of colonic malignancies. Clear distinction between colonic GIST and colonic leiomyosarcoma based on immunomarkers is necessary. Clinical rarity of colonic leiomyosarcoma has translated into only a few case reports detailing the aggressive nature of these tumors.Methods/Interventions: We present the case of a 65 year old male whose initial presenting symptom was syncope. He was found to be profoundly anemic with a hemoglobin of 4.0. After initial resuscitation, he underwent colonoscopy which demonstrated a multi-lobular mass in the ascending colon (Figure 1) which was biopsy proven leiomyosarcoma. Staging scans further characterized the mass (Figure 2 and 3) and did not show evidence of grossly metastatic disease.Results/Outcomes: Given the size of the tumor, he was taken to the operative room for open right hemicolectomy where a 9.9 cm x 8.8 cm x 7.9 cm tumor specimen was excised. His hospital course was uneventful and he was doing well on outpatient follow up.Conclusion/

Discussion: His case was discussed at multi-disciplinary tumor board where he was recommended for surveillance without need for adjuvant treatment."Tumor in Coronal Imaging

Figure 3: Coronal CT scan demonstrating 8.7 x 6.9cm mass
Tumor in Axial Imaging

Figure 2: Axial CT scan demonstrating 8.7 x 6.9cm mass
Tumor in Coronal Imaging

Figure 3: Coronal CT scan demonstrating 8.7 x 6.9cm mass
Excised Tumor Specimen

Figure 4: Right hemicolectomy specimen with ruler through ileocecal valve