前川 陽子¹, 豊川 晃弘¹, 衣笠 達也¹, 深野 茂¹, 関本 健一¹, 奥田 喜啓²

Yoko MAEKAWA¹, Akihiro TOYOKAWA¹, Tatsuya KINUGASA¹, Shigeru FUKANO¹, Kenichi SEKIMOTO¹, Yoshihiro OKUDA²

¹三菱神戸病院外科, ²三菱神戸病院泌尿器科

¹Department of Surgery, Mitsubishi Kobe Hospital, ²Department of Urology, Mitsubishi Kobe Hospital

キーワード : Leiomyosarcoma, Small intestine , Ultrasonography

A leiomyosarcoma of the small intestine was discovered behind the urinary bladder on ultrasonographic (US) examination. The patient was 49-year-old man with dysuria. Routine laboratory studies indicated leukocytosis, but there were no other abnormal findings. A soft mass was palpable through the rectal wall by digital examination. US showed a well-circumscribed, round, cystic lesion that measured 8 X 7 cm. The lesion was predominantly hypoechoic. Dilatation of the small intestine on the side anterior to the lesion was also identified. The pelvic computed tomogram (CT) showed a marginally enhanced low-density mass that contained an air-density spot, and surgery was performed. The tumor, located between the urinary bladder and the rectum, was a cystic mass containing necrotic tissue, and it originated from the small intestine. Histologic examination identified it as a leiomyosarcoma of the small intestine, a rare disease. The nonspecificity of the symptoms and difficulty of preoperative examination complicate the diagnosis. This report suggests the potential value of US findings in cases of leiomyosarcoma of the small intestine.