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BMJ Case Reports 2010; doi:10.1136/bcr.10.2009.2364
  • Reminder of important clinical lesson

Small bowel liposarcoma—a rare cause of small bowel perforation

  1. A G Gordon2
  1. 1Department of General Surgery, Heatherwood and Wexham Park Hospitals NHS Trust, Wexham Park Hospital, Slough, UK
  2. 2Department of Radiology, Wexham Park Hospital, Slough, UK
  1. Correspondence to K S Benaragama, shanka{at}doctors.org.uk

Summary

A 76-year-old patient was admitted with right-sided lower abdominal pain. CT scan of the abdomen demonstrated a fatty mass arising around the bowel in the left iliac fossa causing local distortion of the vasculature.

His clinical condition rapidly deteriorated with worsening abdominal signs necessitating an exploratory laparotomy. A segment of perforated small bowel associated with mesenteric mass was excised and the patient died 3 days later.

The histology demonstrated a well-differentiated liposarcoma. Liposarcomas are the most common soft tissue sarcomas in adults but occurrence in the gastrointestinal tract is extremely rare. The clinical presentation of these tumours is frequently non-specific and commonest symptoms are generalised, intermittent abdominal pain.

Surgical resection with clear margins is the treatment of choice for primary liposarcomas. They are moderately radiosensitive and chemotherapy is non-effective.

Although gastrointestinal liposarcomas have been previously reported, this is the first reported case of a primary liposarcoma associated with a small bowel perforation.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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