小堀 迪夫¹, 徳永 常登¹, 山本 亮輔¹, 斉藤 逸郎¹, 越智 文晴², 佐藤 源³

Michio KOBORI¹, Thuneto TOKUNAGA¹, Ryosuke YAMAMOTO¹, Itsuro SAITO¹, Humiharu OCHI², Gen SATO³

¹瀬戸内海病院内科, ²瀬戸内海病院臨床検査部, ³四国癌センター外科

¹Department of Internal Medicine, Seto Inlandsea Hospital, ²Clinical Laboratory, Seto Inlandsea Hospital, ³Department of Surgery, Shikoku Cancer Center Hospital

キーワード : Leiomyosarcoma, Ultrasonography, Small intestine, Exo-enteric tumor, Cystic formation

　We present a case of leiomyosarcoma of the small intestine.
　A 47-year-old man visited our hospital with complaints of abdominal fullness and epigastric pain for the past three days.
　On abdominal palpation there was a smooth, elastic hard, good movable, fist sized tumor in the left hypogastrium.
　Ultrasonic examination showed a well defined mass containing multiform cystic patterns in the slightly high echoic solid pattern corresponding to some residual parenchyma. Posterior echo enhancement were observed.
　On gastrointestinal series the small intestine was displased by the tumor, and moved with this tumor. There were no abnormal findings in the mucosal pattern of the small intestine. Hence it is assumed that the tumor was closely adherent to the small intestine.
　Preoperative clinical impression was an exo-enteric leiomyosarcoma or a mesenterial polycystic tumor.
　On laparotomy the neoplasm was located 2 m oral from the ileocecal valve, 11×8×8 cm in diameter, growing outside of the small intestinal canal.
　Cut surface of the tumor disclosed multiple cystic areas with irregularities in its inner surface and there was no abnormal finding in the mucosal layer.
　Histological diagnosis was leiomyosarcoma.