[Leiomyosarcoma of the small intestine. Review of the literature apropos of 3 cases].

This study reports three cases of leiomyosarcoma of the small intestine (a rare malignant neoplasm) presenting in our department of general surgery over a period of ten years. Tumors in these three patients were located in the jejunum and clinical features included severe gastrointestinal bleeding, intestinal obstruction and/or abdominal pain. All three patients underwent radical surgery. None received radiotherapy and chemotherapy in addition. One is alive and in complete remission for four years while the other two died, after two and twenty-two months respectively. There follows a discussion, based upon the literature, of epidemiological, histopathological, clinical, diagnostic and treatment aspects. Particular stress is placed upon the difficulty of establishing the diagnosis before surgery, since symptoms are often absent or non-specific and vague until the malignant small bowel tumor has progressed to the point of causing a complication. Surgery continues to play a primary role in the treatment of leiomyosarcoma. Further studies are required to identify prognostic factors and to assess the efficacy of radiotherapy and chemotherapy in this type of malignant neoplasia.