title: Leiomyosarcoma of the small bowel: Report of a case and review of the literature.
abstract: BACKGROUND
  Leiomyosarcoma of the small bowel is an extremely rare form of gastrointestinal malignancy. Small bowel tumours are usually asymptomatic at the early stages, and difficult to visualise by upper and lower endoscopy.
  
  
  METHODS
  An 83-year-old gentleman presented in surgical outpatient clinic with chronic anaemia, abdominal discomfort and a single episode of malaena. Initial OGD and colonoscopy were both unremarkable. Subsequent CT revealed a mass in the right iliac fossa of likely small bowel origin, leading to an urgent laparotomy and resection with primary anastomosis. Histopathology showed a high grade leiomyosarcoma with no signs of metastasis and confirmatory immunological staining. Post-surgery follow up remains unremarkable.
  
  
  CONCLUSIONS
  Leiomyosarcomas of the small bowel are extremely rare entities, particularly following the advent of robust immunohistological diagnostic methods allowing differentiation from GISTs. As small bowel tumours are often not visualised by upper and lower endoscopy, further investigations to visualise the small bowel are crucial, generally in the form of magnetic resonance enterography, CT colonography or wireless capsule endoscopy.
  
  
  CONCLUSIONS
  The treatment of such tumours remains predominantly centred around surgical resection, and prognosis is dependent on tumour size and histological staging.
authors.affiliation: Department of Surgery, East Sussex Healthcare Trust, Conquest Hospital, England, UK.
authors.forename: Joshua
authors.initials: J
authors.lastname: Luis
authors.affiliation: Department of Surgery, East Sussex Healthcare Trust, Conquest Hospital, England, UK.
authors.forename: Farshid
authors.initials: F
authors.lastname: Ejtehadi
authors.affiliation: Department of Radiology, East Sussex Healthcare Trust, Eastbourne District General Hospital, England, UK.
authors.forename: David C
authors.initials: DC
authors.lastname: Howlett
authors.affiliation: Department of Surgery, East Sussex Healthcare Trust, Conquest Hospital, England, UK. Electronic address: imelda.donnellan@esht.nhs.uk.
authors.forename: Imelda M
authors.initials: IM
authors.lastname: Donnellan
keywords: Leiomyosarcoma; Small bowel tumour