A 7-week-old boy presented with a 6-week history of failure to thrive,
acute intestinal obstruction, and an apparently irreducible intussusc
eption (noted on contrast enema). He underwent abdominal exploration,
during which a cecal mass was identified and resected. The mass proved
to be a leiomyosarcoma. Histologically, it was an intermediate-grade
malignancy with a predicted 5-year survival rate of 16% to 23% based o
n data from the adult experience. Three years after resection and with
out having received adjuvant therapy, he is healthy and free of diseas
e. A review of the literature showed that in infants these tumors are
predominantly colonic, compared with the predilection for small intest
inal lesions found in the older pediatric and adult populations. Infan
tile intestinal leiomyosarcomata are rare malignancies that do well if
complete surgical excision of the disease can be accomplished. The hi
stological prognostic indicators proposed for intestinal leiomyosarcom
as in the adult population cannot be extrapolated to infants because w
hen they occur in infants, they appear to be less aggressive, and thes
e patients do well without adjuvant therapy. Copyright (C) 1996 by W.B
. Saunders Company