ENDORECTAL ULTRASOUND AND LEIOMYOSARCOMA OF THE RECTUM

Leiomyosarcomas of the rectum are uncommon neoplasms accounting for fe wer than 1% of all malignancies of the colon and rectum. Approximately 215 cases have been described in the literature. Distinction from lei omyoma is often difficult, but regarding dignity is important. The cas e reported is that of a 68-year-old man in whom a 2.2-cm rectal mass c overed by mucosa was diagnosed by rectoscopy and endorectal ultrasound . After treatment by wide local excision the histological specimen rev ealed a low-grade, highly differentiated leiomyosarcoma. Due to the la ck of a large series of this disease, there is disagreement over the t herapeutic strategy. At the moment a selective treatment approach seem s to be the most frequently advocated. Large tumors and those extendin g beyond the rectal wall are treated by radical surgical resection. Le imyosarcomas less than 2.5 cm in size and confined to the bowel wall c an be treated by wide local excision. Endosonography can provide exact assessment of tumor size and expansion and is of great value in selec ting the appropriate treatment.