Leiomyosarcoma of the colon: A second malignant neoplasm after treatment for a Wilms' tumor

Leiomyosarcoma of the colon is a rare malignancy. We report the case of a 3 3-year-old woman with a leiomyosarcoma of the colon occurring as an intussu sception 30 years after receiving abdominal irradiation for a Wilms' tumor. A review of the prior and current treatment for Wilms' tumor is discussed, as well as the association between second malignancies and abdominal irrad iation. Leiomyosarcoma of the colon usually presents in the fifth and sixth decades of life and is more common in men. The most common symptom is pain . Ninety per cent are diagnosed at surgery for treatment of bleeding, perfo ration, or obstruction. Surgery remains the primary treatment. Leiomyosarco mas of the gastrointestinal tract are radioresistant, and adjuvant chemothe rapy has shown no survival benefit. The overall prognosis is poor, with mea n 5-year survival of 28 per cent. General surgeons need to be aware of the possibility of second malignant neoplasms after primary treatment of childh ood cancers. Proper reporting is essential to study the long-term effects o f early treatment of childhood cancers and in predicting the best treatment outcomes for these patients.