Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2018; 6(8): 219-223
Published online Aug 16, 2018. doi: 10.12998/wjcc.v6.i8.219
Multimodal treatments of right gastroepiploic arterial leiomyosarcoma with hepatic metastasis: A case report and review of the literature
Hyung-Il Seo, Dong-Il Kim, Youngsoo Chung, Chang In Choi, Minjoo Kim, Sungpil Yun, Suk Kim, Do Youn Park
Hyung-Il Seo, Youngsoo Chung, Chang In Choi, Minjoo Kim, Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Dong-Il Kim, Department of Surgery, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
Sungpil Yun, Department of Surgery, On Hospital, Busan 49241, South Korea
Suk Kim, Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Do Youn Park, Department of Pathology, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Author contributions: Seo HI is the first author; Kim DI is the corresponding author of the manuscript; Chung Y and Choi CI analyzed and interpreted the patient data; Kim S reviewed radiologic findings; Park DY did the pathology reading of the slides; Yun S and Kim M were involved in drafting and revising the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Patient records and information were anonymized to protect the personal information.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article, which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dong-Il Kim, MD, Assistant Professor, Department of Surgery, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan 50612, Gyeongsangnam-do, South Korea. led117@naver.com
Telephone: +82-55-3602124 Fax: +82-55-3602154
Received: June 27, 2018
Peer-review started: July 11, 2018
First decision: July 11, 2018
Revised: July 24, 2018
Accepted: August 1, 2018
Article in press: August 1, 2018
Published online: August 16, 2018
Processing time: 50 Days and 7.7 Hours
ARTICLE HIGHLIGHTS
Case characteristics

A 70-year-old man presented with an intra-abdominal mass and a hepatic mass during a follow visit for rectal cancer surgery.

Clinical diagnosis

After CT and magnetic resonance imaging (MRI), it was diagnosed as a malignant gastrointestinal stromal tumor (GIST) with hepatic metastasis.

Differential diagnosis

After the core needle biopsy of the liver, it was diagnosed as a leiomyosarcoma (LMS). Before the surgery, these were omental GIST and hepatic LMS.

Imaging diagnosis

At first, it was diagnosed a omental GIST and hepatic metastasis in CT and MRI.

Pathological diagnosis

The surgical specimen diagnosed as an aLMS with hepatic metastasis.

Treatment

Multimodal treatments were done (three surgeries, chemotherapy, transarterial chemoembolization, radiofrequency, and targeted therapy).

Related reports

There were only nine reports about intra-abdominal arterial leiomyosarcoma (aLMS). This is the first report of intra-abdominal aLMS with hepatic metastasis.

Term explanation

aLMS is a very rare and aggressive disease. The prognosis is very poor. There were few reports of this disease. So the treatment is also not established.

Experiences and lessons

Active treatments using multiple modalities may be helpful for these kinds of patients.