Anorectal leiomyomas: report of two cases with different anatomical patterns and literature review.
Gastrointestinal mesenchymal tumors comprise a rare group of gastrointestinal tract wall tumors that have long been a source of confusion and controversy, especially in terms of pathological classification, preoperative diagnosis, management strategies, and prognosis. This report describes the clinical manifestations and management of 2 rectal leiomyomas and reviews the pertinent literature. Case 1: A 44-year-old woman was admitted reporting a nodule in the right para-anal region for the previous 2 years. At proctological examination, a 4-cm diameter fibrous mass situated in the para-anal region that produced an arch under the smooth muscle on the right rectal wall just above the anorectal ring was noted. Computed tomography and magnetic resonance imaging of the abdomen and pelvis showed the lesion and detected no other abnormalities. Surgical treatment consisted of wide local resection of the tumor through a para-anal incision, with no attempts to perform lymphadenectomy. Case 2: A 40-year-old male patient was admitted reporting constant anal pain for 4 months. He presented a 3-cm submucosal nodule at the anterior rectal wall just above the dentate line. After 2 inconclusive preoperative biopsies, transanal resection of the tumor was performed. Histological analysis of the specimen showed a benign leiomyoma. A review of the literature is presented, emphasizing some clinical and therapeutic aspects of this unusual rectal tumor.
Campos
Fábio Guilherme
FG
Department of Gastroenterology, Coloproctology Unit, Hospital das Clínicas, Faculty of Medicine, University of São Paulo - São Paulo/SP, Brazil. fgmcampos@terra.com.br
Leite
Andrea Furlan
AF
Araújo
Sérgio Eduardo Alonso
SE
Atuí
Fábio César
FC
Seid
Vítor
V
Habr-Gama
Angelita
A
Kiss
Desidério Roberto
DR
Gama-Rodrigues
Joaquim
J
D000328:Adult; D001005:Anus Neoplasms / Q000473:pathology* / Q000601:surgery; D001706:Biopsy; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male