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Case Reports in Gastrointestinal Medicine
Volume 2011, Article ID 358680, 3 pages
http://dx.doi.org/10.1155/2011/358680
Case Report

Retroperitoneal Leiomyosarcoma Presenting as Lower Gastrointestinal Bleeding: A Case Report and Review of the Literature

Allegheny Center for Digestive Health, West Penn Allegheny Health System, Pittsburgh, PA 15212, USA

Received 16 June 2011; Accepted 11 July 2011

Academic Editors: Y. Nakayama, S. S. Saluja, and C. Vogt

Copyright © 2011 Dominic G. Ventura et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report the first known case of a retroperitoneal leiomyosarcoma that presented with an endoscopically defined source of gastrointestinal bleeding in the colon. A 68-year-old male with a history of diverticulosis, hypertension, and hypercholesterolemia who complained of a 3-month history of abdominal pain, nausea, and intermittent hematochezia presented for evaluation of large volume hematochezia and lightheadedness. Colonoscopy revealed left-sided diverticulosis and rectal varices without stigmata of recent bleed. CT scan showed a 26 × 20 × 13 cm heterogeneous retroperitoneal mass and multiple hypodense hepatic lesions. Liver biopsy revealed leiomyosarcoma. In summary, although surgery is the mainstay of treatment, resectability has not improved significantly. Early recognition and aggressive surgery are keys to long-term survival.