[Leiomyosarcoma of Meckel's diverticulum in cystic form].

BACKGROUND

Leiomyosarcoma is an uncommon small bowel tumor. About 60 cases of a Meckel's diverticulum localization have been reported. We present a very rare form of leiomyosarcoma arising in a Meckel's diverticulum, mimicking a very large abdominal cyst.

CASE REPORT: Abdominal ultrasound evidenced a voluminous cystic mass in the abdomen of a 37-year-old man consulting for abdominal discomfort. Computed tomography visualized a tissular component with contrast uptake. Laparotomy was performed with resection of a 4 liter cyst on the Meckel's diverticulum. Histology reported leiomyosarcoma.

DISCUSSION: Leiomyosarcoma of the small bowel mainly develops in an extraluminal localization. Necrotic remodeling explains the cyst formation. Computed tomography with contrast injection can be most helpful for diagnosis. Surgery provides the only possible cure in still localized forms. Other treatments have failed to demonstrate any benefit. Prognosis is mainly related to the histological grading according to the mitotic index.