Surgery Today

, Volume 27, Issue 6, pp 546–549 | Cite as

Leiomyosarcoma originating in Meckel's diverticulum: Report of a case and a review of 59 cases in the English literature

  • Nobuyuki Shimizu
  • Shu Kuramoto
  • Toshiki Mimura
  • Kaoru Kobayashi
  • Masanori Kobayashi
  • Shigeru Sakai
  • Michio Kaminishi
  • Takeshi Oohara
Case Report

Abstract

A 49-year-old woman was referred to our hospital with complaints of epigastric colicky pain and high fever. Abdominal computed tomography and ultrasonography showed a solid tumor in the lower abdomen. Laparotomy revealed a neoplastic mass arising in Meckel's diverticulum; therefore, a segment of the ileum, including the tumor-possessing diverticulum, was resected with a lymph node dissection. A histologic examination confirmed the lesion to be leiomyosarcoma. In the English literature, 59 cases of leiomyosarcoma in Meckel's diverticulum were reported from 1941 to 1994. The majority of patients were in their 4th decade of life, with both sexes equally affected. The most frequent symptoms associated with this disease were abdominal pain with nausea, vomiting, and melena. The majority were larger than egg-size. Although Meckel's diverticulum is difficult to diagnose preoperatively, mesenteric arteriography may at times prove useful. The standard management of this particular tumor is wide segmental resection, including the tumor and diverticulum with lymph node dissection.

Key Words

Meckel's diverticulum leiomyosarcoma diagnosis management 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Mackey WC, Dineen P (1983) A fifty-year experience with Meckel's diverticulum. Surg Gyn Obst 156:56–64PubMedGoogle Scholar
  2. 2.
    Weinstein EC, Cain JC, ReMine WH (1962) Meckel's diverticulum. JAMA 182:251–253PubMedGoogle Scholar
  3. 3.
    Kusumoto H, Yoshida M, Takahashi I, Anai H, Maehara Y, Sugimachi K (1992) Complications and diagnosis of Meckel's diverticulum in 776 patients. Am J Surg 164:382–383PubMedGoogle Scholar
  4. 4.
    Williams RS (1981) Management of Meckel's diverticulum. Br J Surg 68:477–480PubMedGoogle Scholar
  5. 5.
    Moore T, Johnston AOB (1976) Complication of Meckel's diverticulum. Br J Surg 63:453–454PubMedGoogle Scholar
  6. 6.
    DeBartolo HM, Van Heerden JA (1976) Meckel's diverticulum. Ann Surg 183:30–33PubMedGoogle Scholar
  7. 7.
    Dixon AY, McAnaw M, McGregor DH, Keushkerian S, Miller LK, Pierce PD (1988) Dual carcinoid tumors of Meckel's diverticulum presenting as metastasis in an inguinal hernia sac: case report with literature review. Am J Gastroenterol 83:1283–1288PubMedGoogle Scholar
  8. 8.
    De Mulder RM, Verschave JG (1991) Perforated leiomyosarcoma of Meckel's diverticulum. Eur J Surg 157:69–70PubMedGoogle Scholar
  9. 9.
    Saadia R, Decker GAG (1986) Leiomyosarcoma of Meckel's diverticulum: Case report and review of the literature. J Surg Oncol 32:86–88PubMedGoogle Scholar
  10. 10.
    Niv Y, Abu-Avid S, Kopelman C, Oren M (1986) Torsion of leiomyosarcoma of Meckel's diverticulum. Am J Gastroenterol 81:288–291PubMedGoogle Scholar
  11. 11.
    Sheth M, Rosenberg V, Kim U (1978) Perforated leiomyosarcoma of Meckel's diverticulum: A case report and review of literature. Mount Sinai J Med 45:322–328Google Scholar
  12. 12.
    Rao PG, Katariya RN, Sood S, Banerjee AK (1976) Leiomyosarcoma of Meckel's diverticulum. Ind J Cancer 13:381–382Google Scholar
  13. 13.
    Haugen OA, Pegg CS, Kyle J (1970) Leiomyosarcoma of Meckel's diverticulum. Cancer 26:929–934PubMedGoogle Scholar
  14. 14.
    Chatterjee CR (1970) Sarcomas of Meckel's diverticulum. Can J Surg 13:163–165PubMedGoogle Scholar
  15. 15.
    Lie JT (1966) Leiomyosarcoma of Meckel's diverticulum. Br J Surg 53:336–339PubMedGoogle Scholar
  16. 16.
    Hill FA, Janelli DE (1953) Malignant tumors originating in Meckel's diverticulum. Am J Surg 85:525–528CrossRefPubMedGoogle Scholar
  17. 17.
    Weinstein EC, Dockerty MB, Waugh JM (1963) Neoplasms of Meckel's diverticulum. Int Abst Surg 116:103–111Google Scholar
  18. 18.
    Kusumoto H, Yoshitake H, Mochida K, Kumashiro R, Sano C, Inutsuka S (1992) Adenocarcinoma in Meckel's diverticulum: Report of a case and review of 30 cases in the English and Japanese literature. Am J Gastroenterol 87:910–913PubMedGoogle Scholar
  19. 19.
    Swinnen E, Meeus L, Pattyn G, Vandevoorde P, Steyaert L (1986) Leiomyoma in Meckel's diverticulum: CT and angiographic studies in one case. JBR BTR 69:355–357Google Scholar
  20. 20.
    Tabry IF, Nassar VH, Balikian JP (1973) Leiomyoma of Meckel's diverticulum—preoperative radiologic demonstration. Ann Surg 178:31–33PubMedGoogle Scholar
  21. 21.
    Deck KB, Silberman H (1979) Leiomyosarcomas of the small intestine. Cancer 44:323–325PubMedGoogle Scholar
  22. 22.
    Starr GF, Dockerty MB (1955) Leiomyomas and leiomyosarcomas of the small intestine. Cancer 8:101–111PubMedGoogle Scholar
  23. 23.
    Lee YN, Silberman H, Deck KB (1980) Leiomyosarcoma of the gastrointestinal tract: Should we consider metastasis to regional lymph nodes? J Surg Oncol 15:319–321PubMedGoogle Scholar
  24. 24.
    Choi TK, Ng A, Wong J (1985) Doxorubicin, dacarbazine, vincristine, and cyclophosphamide in the treatment of advanced gastrointestinal leiomyosarcoma. Cancer Treat Rep 69:443–444PubMedGoogle Scholar
  25. 25.
    Yap BS, Baker LH, Sinkovics JG, Rivkin SE, Bottomley R, Thigpen T, Burgess MA, Benjamin RS, Bodey GP (1980) Cyclophosphamide, vincristine, Adriamycin, and DTIC combination chemotherapy for the treatment of advanced sarcomas. Cancer Treat Rep 64:93–98PubMedGoogle Scholar
  26. 26.
    Ranchod M, Kempson RL (1977) Smooth muscle tumors of the gastrointestinal tract and retroperitoneum. Cancer 39:255–262PubMedGoogle Scholar
  27. 27.
    Kieffer RW, McSwain B, Adkins RB (1982) Sarcoma of the gastrointestinal tract: a review of 40 cases. Am Surg 48:167–169PubMedGoogle Scholar
  28. 28.
    He LJ, Wang BS, Chen CC (1988) Smooth muscle tumor of the digestive tract: report of 160 cases. Br J Surg 75:184–186PubMedGoogle Scholar
  29. 29.
    Akwari OE, Dozois RR, Weiland LH, Beahrs OH (1978) Leiomyosarcoma of the small and large bowel. Cancer 42:1375–1384PubMedGoogle Scholar
  30. 30.
    McGrath PC, Neifeld JP, Lawrence W, Kay S, Horsley JS, Parker GA (1987) Gastrointestinal sarcomas. Ann Surg 206:706–710PubMedGoogle Scholar
  31. 31.
    Ng EH, Pollock RE, Romsdahl MM (1992) Prognostic implications of patterns of failure for gastrointestinal leiomyosarcomas. Cancer 69:1334–1341PubMedGoogle Scholar
  32. 32.
    Skandalakis JE, Gray SW, Shepard D (1964) Smooth muscle tumors of the small intestine. Am J Gastroenterol 42:172–190PubMedGoogle Scholar
  33. 33.
    Kohno H, Nagasue N, Araki S, Kato T (1980) Ten-year survival after synchronous resection of liver metastasis from intestinal leiomyosarcoma. Cancer 47:1421–1423Google Scholar
  34. 34.
    Shiu MH, Farr GH, Egeli RA, Quan SHG, Hajdu SI (1983) Myosarcomas of the small and large intestine: a clinicopathologic study. J Surg Oncol 24:67–72PubMedGoogle Scholar
  35. 35.
    Ng EH, Pollock RE, Munsell MF, Atkinson EN, Romsdahl MM (1992) Prognostic factors influencing survival in gastrointestinal leiomyosarcomas. Ann Surg 215:68–77PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • Nobuyuki Shimizu
    • 1
  • Shu Kuramoto
    • 1
  • Toshiki Mimura
    • 1
  • Kaoru Kobayashi
    • 1
  • Masanori Kobayashi
    • 1
  • Shigeru Sakai
    • 1
  • Michio Kaminishi
    • 1
  • Takeshi Oohara
    • 1
  1. 1.Third Department of SurgeryUniversity of TokyoTokyoJapan

Personalised recommendations