LEIOMYOSARCOMA OF SMALL INTESTINE PRESENTING AS FEVER OF UNKNOWN ORIGIN DUE TO SPONTANEOUS PERFORATION

Abstract

We report a patient with a jejunal leiomyosarcomawho
presented with fever of
unknownorigin. Resection of the tumour
resulted inresolution of his symptoms.
Jejunal leiomyosarcoma is a rare
tumour consistingThe commonest site for
these gastrointestinal stromal tumours is
stomach (39) followed by small intestine
(32), rectum (10), large intestine (5), others
(mesentery, omental, oesophagus,
diaphragm), intestine unspecified (5).4 In
the small intestine it is commonest in the
jejunum followed by ileum, duodenum
and Meckels diverticulum Patients with
thisof smooth muscle cells. tumour generally
present with vague symptomssuch
as abdominal pain, chronic anaemia, ordiarrhoea
and because of this and the
lowsensitivity of most diagnostic studies -
forexample, enteroclysis, computed tomography,
and echography - jejunal leiomyosarcoma
isnotoriously difficult to diagnose
at an early stage.
Histologically, differential diagnosis betweenleiomyoma
and leiomyosarcoma is
not clear cut,as it is based on a number of
differentiatingfeatures with a wide overlap.
The tumourtypically spreads by direct invasion
and haematogenouslyto the liver,
lungs, and bone. Theonly proved treatment
is resection, with a fiveyear survival of 40-
60per cent.