Leiomyosarcoma of the gonadal vein is an exceedingly rare entity, representing a small subset of smooth muscle tumors that more commonly arise in the retroperitoneum, uterus, and blood vessels. To date, fewer than 10 ...Leiomyosarcoma of the gonadal vein is an exceedingly rare entity, representing a small subset of smooth muscle tumors that more commonly arise in the retroperitoneum, uterus, and blood vessels. To date, fewer than 10 cases of gonadal vein leiomyosarcoma have been reported in the literature, highlighting its rarity and the limited understanding of its clinical behavior. These tumors are often diagnosed incidentally or present with nonspecific symptoms, such as abdominal pain or a palpable mass, which can complicate early detection. The proximity of gonadal vein leiomyosarcomas to critical structures, such as the ureter, renal vessels, and surrounding organs, introduces unique diagnostic and surgical challenges. Previous reports have underscored the importance of advanced imaging techniques, including CT and MRI, in delineating the tumor’s anatomical relationships and guiding surgical planning. This case, involving a leiomyosarcoma closely associated with the patient’s left ureter, provides an opportunity to build on existing knowledge by addressing the clinical presentation, diagnostic approach, treatment pathway, and long-term follow-up strategies required for optimal management. By presenting this detailed review, we aim to contribute valuable insights into the diagnosis and management of this rare malignancy.展开更多
Background/Aim: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. However, they only constitute approximately 1% of all primary GI tumors. GISTs are most com...Background/Aim: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. However, they only constitute approximately 1% of all primary GI tumors. GISTs are most commonly found in the stomach (60% - 70%) and small intestine (20% - 30%). Colorectal (5%) and esophageal (Presentation of Clinical Case: A 33-year-old male, presented to the emergency department for melena and dizziness in January 2023. He was hospitalized several times for anemia with multiple blood transfusions since 2017 and never made a final diagnosis. From 2017 to 2019 he underwent esophagogastroduodenoscopy (EGD) and ileocolonoscopy 3 times which always gave a negative result. At this time, laboratory results showed microcytic anemia with hemoglobin 7 g/dl. We performed an EGD and ileocolonoscopy again but still showed negative then we did an abdominal CT scan with contrast with demonstrated a solid exophytic hypervascular mass measuring 62 × 38 × 73 mm that appeared to arise from the duodenojejunal junction. The surgeon decided to proceed with surgical resection of the mass and the histopathologist confirmed the diagnosis of GISTs. The patients were discharged in stable condition after the surgery and followed up every 3 - 6 months with the oncologist. Conclusion: The presentation of chronic GI bleeding with negative results in EGD and ileocolonoscopy, and abdominal CT scan with contrast could provide useful information in order to obtain a diagnosis of bleeding GISTS. Teamwork is the cornerstone in the management of the case. After the resection of the mass by the surgeon, the histopathologist allowed us to establish the definitive diagnosis and the oncologist will follow up with this patient in order to prevent the relapse of symptoms.展开更多
文摘Leiomyosarcoma of the gonadal vein is an exceedingly rare entity, representing a small subset of smooth muscle tumors that more commonly arise in the retroperitoneum, uterus, and blood vessels. To date, fewer than 10 cases of gonadal vein leiomyosarcoma have been reported in the literature, highlighting its rarity and the limited understanding of its clinical behavior. These tumors are often diagnosed incidentally or present with nonspecific symptoms, such as abdominal pain or a palpable mass, which can complicate early detection. The proximity of gonadal vein leiomyosarcomas to critical structures, such as the ureter, renal vessels, and surrounding organs, introduces unique diagnostic and surgical challenges. Previous reports have underscored the importance of advanced imaging techniques, including CT and MRI, in delineating the tumor’s anatomical relationships and guiding surgical planning. This case, involving a leiomyosarcoma closely associated with the patient’s left ureter, provides an opportunity to build on existing knowledge by addressing the clinical presentation, diagnostic approach, treatment pathway, and long-term follow-up strategies required for optimal management. By presenting this detailed review, we aim to contribute valuable insights into the diagnosis and management of this rare malignancy.
文摘Background/Aim: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. However, they only constitute approximately 1% of all primary GI tumors. GISTs are most commonly found in the stomach (60% - 70%) and small intestine (20% - 30%). Colorectal (5%) and esophageal (Presentation of Clinical Case: A 33-year-old male, presented to the emergency department for melena and dizziness in January 2023. He was hospitalized several times for anemia with multiple blood transfusions since 2017 and never made a final diagnosis. From 2017 to 2019 he underwent esophagogastroduodenoscopy (EGD) and ileocolonoscopy 3 times which always gave a negative result. At this time, laboratory results showed microcytic anemia with hemoglobin 7 g/dl. We performed an EGD and ileocolonoscopy again but still showed negative then we did an abdominal CT scan with contrast with demonstrated a solid exophytic hypervascular mass measuring 62 × 38 × 73 mm that appeared to arise from the duodenojejunal junction. The surgeon decided to proceed with surgical resection of the mass and the histopathologist confirmed the diagnosis of GISTs. The patients were discharged in stable condition after the surgery and followed up every 3 - 6 months with the oncologist. Conclusion: The presentation of chronic GI bleeding with negative results in EGD and ileocolonoscopy, and abdominal CT scan with contrast could provide useful information in order to obtain a diagnosis of bleeding GISTS. Teamwork is the cornerstone in the management of the case. After the resection of the mass by the surgeon, the histopathologist allowed us to establish the definitive diagnosis and the oncologist will follow up with this patient in order to prevent the relapse of symptoms.
