We report a case of leiomyosarcoma of the colon whose first manifestation was pulmonary metastasis.
This is a 74-year-old woman with a history of chronic obstructive pulmonary disease and hysterectomy with double adnexectomy and subsequent brachytherapy for endometrial adenocarcinoma 5 years ago.
She complained of dyspnea for two months without cough, hemoptysis or associated general syndrome.
Blood tests were normal.
A chest X-ray and a thoracic CT scan showed a right parahilar mass of 5 x 3 cm. A biopsy of this mass was performed through bronchoscopy, which showed a tumor of mesenchymal origin compatible with lei vimentKn.
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An extension study was carried out with gastroscopy, adenocarcinoma and CT scan to non-pelvic junction which was negative.
Right pneumonectomy was performed with a diagnosis of primary leiomyosarcoma of the right lung, confirming the histology of leiomyosarcoma in the surgical specimen.
One month after right pneumonectomy, the patient developed abdominal pain with nausea, vomiting and episodes of rectal bleeding.
It is compatible with terminal lesion showing a polylocular mass of neoplasic appearance in ascending-blind colon and abdominal CAT with dilatation of small intestine loops visualizing an image in "donuts" underlying intestinal tumor level.
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Emergency surgery was performed and obstruction of the small intestine was observed invagination of the terminal ileum at the cecum tumor level.
Right hemicolectomy was performed.
Histopathological study of the surgical specimen shows that it is a leiomyosarcoma of 6 x 4 x 2.8 cm, affecting the mucosa, submucosa, muscle and serosa with a high number of mitoses (+ fields of 10 mitosis).
This finding demonstrates that LMS had its origin in the colon and the lung tumor was metastatic.
During this second postoperative period, the patient again presented respiratory complications and died one month after abdominal surgery.
