A case of large duodenal leiomyosarcoma.

概要

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We experienced one patient with an infant's head-sized duodenal leiomyosarcoma showing extratubal development. The patient was a 72-year-old man who had sufferd from pain in the right hypochondorial region at onset of the condition. A mass about 10 cm in diameter was palpated in the right hypochondrial region. Roentgenographic examination of the upper digestive tract revealed an image similar to a submucosal tumor associated with a depression in the middle portion of the descending duodenal loop. Endoscopy revealed this central depression to be a fistula. Cytologocal feature of aspirated material by fisterography revealed spindle cells that were probably non-epithelial origin. The condition was diagnosed as a non-epithelial malignant tumor, and pancreatoduodenectomy was undertaken. The lesion was histologically confirmed to be leiomyosarcoma originated from the duodenum. There have been few reported cases of leiomyosarcoma of the duodenum associated with fistula. This present case was, therefore, considered to be an interesting one in which endoscopic f isterography and aspiration cytodiagnosis proved useful for the diagnosis.
社団法人日本消化器内視鏡学会の論文