Small bowel obstruction due to cecal leiomyoma:
 a rare presentation and case report

Chegini , Reihane; Seyed Sharifi , Seyed Hasan; Nikdel , Rasul

Volume 82, Issue 5 (August 2024) Tehran Univ Med J 2024, 82(5): 431-435 | Back to browse issues page

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Chegini R, Seyed Sharifi S H, Nikdel R. Small bowel obstruction due to cecal leiomyoma: a rare presentation and case report. Tehran Univ Med J 2024; 82 (5) :431-435
URL: http://tumj.tums.ac.ir/article-1-13175-en.html

Small bowel obstruction due to cecal leiomyoma: a rare presentation and case report

Reihane Chegini¹

, Seyed Hasan Seyed Sharifi²

, Rasul Nikdel ^*

1- Department of Pathology, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
2- Department of General Surgery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
3- Department of General Surgery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran. , rasul.nikdel@yahoo.com

Abstract: (15 Views)

Background: Benign tumors of the gastrointestinal tract with a muscular origin are typically found in the esophagus, stomach, or small intestine, and rarely in the large intestine. Approximately 3% of all gastrointestinal leiomyomas occur in the large intestine, primarily in the descending colon and sigmoid colon. These lesions are usually asymptomatic and are often discovered during endoscopic procedures.
Case Presentation: A 38-year-old female patient admitted to the emergency department of Imam Ali Hospital in Bojnurd city in January 2024, reporting vague and nonspecific lower abdominal pain, abdominal distension, nausea, vomiting, low appetite and signs of partial gastrointestinal obstruction over the past week that don’t have any history of weight loss, gastrointestinal bleeding, constipation or family history of cancer. Her symptoms had not responded to Over-the-counter (OTC) medicines and outpatient treatment. Given the nonspecific manifestations, a CT scan of the abdomen and pelvis with iv contrast was requested for further evaluation of inta abdominal disease. The CT findings indicated a 5.5 cm lesion at the beginning of the large intestine, which exerted pressure on the distal part of small intestine, leading to evidence of partial obstruction of the distal part of small intestin. The patient was diagnosed with small bowel obstruction due to an ascending colon tumor and was scheduled for surgical intervention. She underwent resection of right colon, 10-15 cm of terminal ileum along with drainage of the regional lymph nodes. The excised tissue sample was sent for histopathological examination, which suggested a benign colon tumor likely to be a leiomyoma. To facilitate a more accurate diagnosis, immunohistochemical analysis was recommended, which confirmed the diagnosis of leiomyoma.
Conclusion: Colonic leiomyomas can present with various symptoms depending on their size and location. Due to the difficulty in differentiating leiomyomas from malignant colonic tumors, particularly when they are larger, surgical intervention is often recommended. This case highlights the importance of early diagnosis and appropriate management strategies for these tumors to prevent potential complications.

Keywords: colonic neoplasm, leiomyoma, surgical procedure.

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Type of Study: Case Report |