Rare cause of a lower gastrointestinal bleeding

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Published Dec 2, 2010
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Vol. 88 No. 12 (2010): Issue Dec 2010

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Amir Moussi
Ramzi Nouira
Belgacem Bourguiba
Sami Daldoul
Abdeljelil Zaouche

Abstract

Background : Leiomyoma of the colon are rare benign smooth
muscle tumours.
Aim: Report a new case of colic leiomyoma revealed by
gastrointestinal bleeding.
Case: A 71-year-old man, diabetic, consulted the emergencies for
acute per-rectal bleeding. The physical examination was essentially
normal. Haemoglobin level was 3.7g/dl.. The upper digestif
endoscopy was normal. The colonoscopy showed an active bleeding
from the right colon but it was enable to specify the nature and the
exact seat of the bleeding lesion. An emergent operation showed a
tumor of the right colic angle of 8 cm. A right hemicolectomy was
performed with immediate ileocolic anastomosis. Pathology showed
a leiomyoma. Postoperative course mentioned a nosocomial
pneumopathy.
Conclusion: Colic leiomyomas are rare benign tumours. The determination of the mitotic index is of primary importance to differentiate them from the leiomyosarcomas of low rank of malignancy whose prognosis is unfavourable.

Keywords:

leiomyoma, smooth muscle tumour, stromal tumour, colon, Immunohistochemistry

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References

  1. Costaglioli B, Descargues G, Songne B, Mace P, Scotte M. Extraluminal leiomyoma of the sigmoid colon and of the peritoneum. Gastroenterol Clin Biol 2003; 27: 125-7.
  2. Chow WH, Kwan WK, Ng WF. Endoscopic removal of leiomyoma of the colon. HKMJ 1997; 3: 325-7.
  3. Kadakia SC, Kadakia AS, Seargent K. Endoscopic removal of colonic leiomyoma. J Gastroenterol Hepatol 1996; 11: 299-300.
  4. Hatch KF, Blanchard DK, Hatch GF, et al. Tumors of the appendix and colon. World J Surg 2000; 24: 430-36.
  5. Tarasidis G, Brown BC, Skandalakis LJ et al. Smooth muscle tumor of the appendix and colon: a collective review of the world literature. J Med Assoc Ga 1991; 80: 667-83.
  6. Ouchi J, Araki Y, Chijiiwa Y et al. Endosonographic probeguided endoscopic removal of colonic pedunculated leiomyoma. Acta Gastro-Enterol Belgica 2000; 63: 314-6.
  7. Chun HJ, Byun JY, Chun KA et al. Gastrointestinal leiomyoma and leiomyosarcoma: CT differentiation. J Comput Assist Tomogr 1998; 22:69-74.
  8. Cummings SP, Lally KP, Pineiro-Carrero V, Beck DE. Colonic leiomyoma. An unusual cause of gastrointestinal haemorrhage in childhood. Dis Colon Rectum 1990; 33: 511-14.
  9. Glaser H, Chanon B. Multiple metastases of a benign leiomyoma. About a case. Review of yhe literature. Pathologic concepts and therapeutic stance. J Gynecol Obstet Biol Reprod 1984; 13: 531-9.