We report the case of a 69-year-old woman who came to the emergency department of our center with diffuse abdominal pain accompanied by rectal bleeding for 5 days, abnormal bowel rhythm, hypoxia and fever.
Physical examination revealed hemodynamic stability and pain upon deep fixation of the epigastrium with no signs of peritoneal irritation. A mass in the right hemiabdomen was observed, suggesting a tumor at this level.
Laboratory tests showed elevated C-reactive protein, leukocytosis with neutrophilia and anemia.
On plain abdominal radiography, air was observed in an isolated loop in the right flank with air-fluid level inside.
Abdominal CT showed an image of colonic invagination at the cecum, whose head reached the proximal third of the transverse colon, secondary to polypoid tumor of 4-5 cm. An urgent diagnosis was made hemicolectomy.
Pathological examination revealed a high ulcerated mesenchymal neoformation with intense cytoplasmic immunoreactivity to vimentin, actin and calponin (42/10) and mitotic fields.
No metastatic involvement was observed in any of the lymph nodes removed (0/12).
The definitive diagnosis was compatible with high grade intestinal leiomyosarcoma.
