RECURRENCE OF A RENAL MYOGENIC TUMOR PRESENTED AS A DUODENAL ULCERATED LESION

Background/Aims: The authors report on an extremely rare case of a rec urrent myogenic tumor of renal origin presented exclusively with gastr ointestinal signs and symptoms resulting from duodenal invasion. Patie nts and Materials: A 49-yr-old woman was admitted for epigastric pain and recent history of melenae. She had been submitted to right nefrect omy due to a smooth muscle tumor five years ago. Results: Pathology de scribed it as a bizarre leiomyoma. Diagnostic procedures showed lobula ted and ulcerated lesions in the duodenum, a nodule within the anterio r abdominal wall, a large neoplasm fulfilling the right renal loca and invading the duodenum, and another nodule at the left kidney. Histolo gical features of all tumors were similar to those seen in the primary renal tumor. The abdominal wall nodule was the only resectable lesion . Although biopsies taken initially from the duodenal lesions failed t o reveal smooth muscle tissue, they were repeated one year later and d isclosed duodenal invasion from a leiomyosarcoma. Conclusion: This ext remely rare case illustrates the striking disagreement between patholo gical diagnosis and clinical course of smooth muscle tumors that somet imes occur.