星 進悦

Shinetsu HOSHI

釜石市民病院　内科

Department of Internal Medicine, Kamaishi Municipal Hospital

キーワード : Primary mesenteric tumor, Epithelioid leiomyosarcoma, Ultrasonography, Mixed pattern, Pseudokidney sign

A case of primary epithelioid leiomyosarcoma of the mesenterium was discovered in an 85-year-old man, who was admitted for the examination and treatment of right upper abdominal pain. Ultrasonography demonstrated an irregular tumor with clear margins, and with a heterogeuous internal echo. The hyperechoic solid components were mainly situated in the middle region of the mass, while the small anechoic area was more centrally located. Some posterior acoustic enhancement was noted. The tumor seemed to involve the intestine, like a pseudokidney sign. A barium enema and colonofiberscopy showed a Borrmann Il-like lesion at the ascending colon, which seemed to be the externally invaded one.
Operative findings indicated that the hand-grip-sized tumor, a primary sarcoma of the mesenterium, involved the 2 nd portion of the duodenum, ileum, and ascending colon. A pathological diagnosis of the tumor indicated epithelioid leiomyosarcoma.