LEIOMYOSARCOMA OF THE RECTUM

The distinction between leiomyoma and high differentiated leiomyosarco ma can be difficult. The most important distinguishing feature is the number of mitoses. Additionally the tightness of the cells, the number of necroses and cell atypias and the size of the tumor are significan t. The most common therapy for large and low differentiated leiomyosar comas of the rectum are the abdomino-perineal resection or the low ant erior resection. In high graded tumors of less than 2,5 cm the radical ity of the surgical treatment is questioned. Some authors recommend a wide local excision, but in this case a high local recurrence rate has to be expected. This is the reason for a more radical treatment of al l leiomyosarcomas of the rectum. Chemotherapy and radiotherapy are gen erally not effective. The prognosis is poor.