Leiomyosarcoma: A Rare Cause of Colocolic Intussusception

Abstract

Intussusception is an infrequent presentation in adult patients and accounts for less than 1% of all cases of adult bowel obstruction. Colon is most commonly involved site and in 56% cases, the underlying cause is a malignant neoplasm. Leiomyosarcoma of colon is an extremely rare tumour. A 30-year-old male patient presented to the Surgery Department with chief complaints of dull, diffuse and colicky abdominal pain associated with abdominal distension and vomiting for 15 days. On abdominal examination, abdomen was distended with generalised tenderness and rigidity. X-ray abdomen showed features suggestive of bowel obstruction. Contrast Enhanced Computed Tomography (CECT) revealed bowel within bowel appearance of a segment of descending colon suggestive of colocolic intussusception. Exploratory laparotomy revealed colocolic intussusception with a large obstructing growth in the descending colon acting as a lead point. Left hemicolectomy with colocolic anastomosis was done. Final histopathological report confirmed epithelioid leiomyosarcoma. Adjuvant chemotherapy was administered and the patient is disease free at one year of follow-up. Present case report was a rare case of colonic leiomyosarcoma presenting with intussusception. The rarity of this disease and the rare presentation makes this an interesting case. Surgical management remains the mainstay of treatment of these cases.