小牧 宏一¹, 山田 勉², 斎藤 頴¹, 小沢 友紀雄¹

Koichi KOMAKI¹, Tsutomu YAMADA², Satoshi SAITO¹, Yukio OZAWA¹

¹日本大学医学部第二内科, ²日本大学医学部第二病理

¹The Second Department of Internal Medicine, Nihon University School of Medicine, ²The Second Department of Pathology, Nihon University School of Medicine

キーワード : Leiomyosarcoma of ileum, Cardiac metastasis, Echocardiography

A rare case of leiomyosarcoma of ileum with cardiac (right ventricular outflow) metastasis is described. A 49-year-old man was admitted to another hospital because of the sudden onset of illness on January 12, 1989. On January 20, abdominal ileus, peritonitis and a state of shock developed. He was transferred to our hospital on January 21. During the operation on the ileus, ileum pedunculated tumor was identified. The submitted specimen was diagnosed as a leiomyosarcoma of ileum. A large tumor echo was recognized in the right ventricular cavity by echocardiography. Although his clinical condition showed a little improvement, DIC was developed and he died at March 8. Autopsy was performed. A solid metastatic tumor measuring 10×8×4 cm was found in the right ventricular space. Microscopically, neoplastic cells showed direct invasion of the right ventricular wall, ventricular septum, and tricuspid valve. Other metastatic tumors were identified in the lung and brain. To date, only 277 cases of leiomyosarcoma of the small intestine have been reported in Japan. No case of leiomyosarcoma of the small intestine with metastasis to the right ventricular cavity has been reported to date in Japan.