Benefits of endorectal ultrasound for management of smooth-muscle tumor ofthe rectum - Report of three cases

Smooth-muscle tumor of the rectum is rare, and the therapeutic strategy is still controversial. Endorectal ultrasound was used to evaluate three patie nts with smooth-muscle tumor of the rectum. Endorectal ultrasound demonstra ted a homogenous hypoechoic tumor without invasion to the perirectal tissue in two patients. The tumor was 5 cm in diameter in one patient and 4 cm in diameter in the other patient, and they were excised locally. Their histol ogic types were leiomyoma and leiomyosarcoma. The third patient had a recur rent leiomyosarcoma. Proctosigmoidoscopy found a linear lesion with ulcerat ed mucosa on the rectal wall. Endorectal ultrasound observed a hypoechoic s olid tumor of 3.5 cm x 1 cm, which involved the mucosal, submucosal, and mu scle layers of the rectal wall. Disruption of the first hypoechoic layer wa s identified. Abdominoperineal resection was performed. Endorectal ultrasou nd follow-up revealed no evidence of recurrence in any of these patients. E ndorectal ultrasound can help to define the extent of disease and may be a useful adjunct in deciding about the appropriate surgical procedure in thes e diseases.