Leiomyosarcoma of the superior mesenteric artery: a case report.

Arterial leiomyosarcoma (A-LMS) is a very rare tumour and no cases originating from the superior mesenteric artery (SMA) have been described. We present a case of A-LMS originating from distal part of SMA and incorporating superior mesenteric vein (SMV). SMA and SMV were prepared along their course by laparotomy. Prior to resection, the superior mesenteric vessels were clamped, and intra-operative infrared angiography after intravenous injection of indocyanine green was performed. Once confirmed the vitality of the bowel, mass resection including the distal portion of the SMA and SMV was executed. The postoperative course was uneventful. Histology confirmed initial diagnosis. Six months after surgery no recurrence was highlighted. This is the first case of A-LMS originating from SMA, successfully treated without any intestinal resection or vascular reconstruction. The use of near-infrared angiography associated with a preoperative angiographic workup is indispensable for the success of the surgery.