title: A very rare case of a small bowel leiomyosarcoma leading to ileocaecal intussusception treated with a laparoscopic resection: a case report and a literature review.
abstract: BACKGROUND
  Small bowel tumours are rare and comprise less than 2% of all primary gastrointestinal neoplasms. Among these tumours, a leiomyosarcoma belonging to soft tissue sarcomas is extremely rare and accounts for about 1 % of malignant mesenchymal lesions in the gastrointestinal tract. Due to its aggressive nature and slow growth, it is often diagnosed at the late stage when curative treatment is impossible. Authors report a first case of leiomyosarcoma with chronic recurrent ileocaecal intussusception and literature review to analyse diagnosis and treatment features of the ileum mesenchymal tumours.
  
  
  METHODS
  We present a case of an 87-year-old Caucasian man suffering from cramp-like abdominal pain for months. Due to lack of clinical signs and unspecific complaints, a diagnosis was delayed. Despite a detailed in-hospital examination, a proper diagnosis was established as late as during an operation. The patient was treated by surgery with good results. An uncommon laparoscopic resection of the small bowel with a tumour was performed. A histopathological investigation confirmed a very rare mesenchymal lesion of the distal ileum. The patient is under control with no recurrence for 1 year of the follow-up period.
  
  
  CONCLUSIONS
  Reported case indicates that a usually asymptomatic tumour can cause uncommon chronic recurrent ileus signs. CT and MRI scans are investigation of choice in such cases, but they are sometimes inconclusive. It might be worth highlighting the good results of laparoscopic leiomyosarcoma lesion resection with a very good outcome.
authors.affiliation: Department of General, Gastroenterological and Oncologic Surgery, Medical University of Warsaw, ul. Banacha 1a, 02-097, Warsaw, Poland. tomasz.guzel@gmail.com.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Guzel
authors.affiliation: Department of General, Gastroenterological and Oncologic Surgery, Medical University of Warsaw, ul. Banacha 1a, 02-097, Warsaw, Poland. kasiamech1895@gmail.com.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Mech
authors.affiliation: Chair and Department of Pathomorphology, Medical University of Warsaw, ul.Pawińskiego 7, 02-097, Warsaw, Poland. mimazurkiewicz@wp.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Mazurkiewicz
authors.affiliation: Department of General, Gastroenterological and Oncologic Surgery, Medical University of Warsaw, ul. Banacha 1a, 02-097, Warsaw, Poland. bohdan.dabrowski@wum.edu.pl.
authors.forename: Bohdan
authors.initials: B
authors.lastname: Dąbrowski
authors.affiliation: Department of General, Gastroenterological and Oncologic Surgery, Medical University of Warsaw, ul. Banacha 1a, 02-097, Warsaw, Poland. gustaw.lech@wum.edu.pl.
authors.forename: Gustaw
authors.initials: G
authors.lastname: Lech
authors.affiliation: Department of General, Gastroenterological and Oncologic Surgery, Medical University of Warsaw, ul. Banacha 1a, 02-097, Warsaw, Poland. andrzej.chaber@wum.edu.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Chaber
authors.affiliation: Department of General, Gastroenterological and Oncologic Surgery, Medical University of Warsaw, ul. Banacha 1a, 02-097, Warsaw, Poland. maciej.slodkowski@wum.edu.pl.
authors.forename: Maciej
authors.initials: M
authors.lastname: Słodkowski
mesh_terms: D000369:Aged, 80 and over; D002429:Cecal Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D007421:Intestine, Small / Q000473:pathology*; D007443:Intussusception; D007890:Leiomyosarcoma / Q000150:complications* / Q000473:pathology; D008297:Male; D011379:Prognosis