Duodenal leiomyosarcoma and its multiple recurrences: good surgical result after three years of follow-up.

Duodenal leiomyosarcoma is a rare tumor and its current prognosis is poor. A case of duodenal leiomyosarcoma is described which recurred five years after the first intestinal resection, and was treated successfully with pancreaticoduodenectomy (PCD), extensive small bowel resection, and transverse, descending and sigmoid colon removal. The patient is still alive three years after this operation. Preservation of the stomach and the first duodenal portion after PCD most likely reduced the malabsorption, which is expected following such radical intestinal resection. This experience suggests an aggressive surgical approach to duodenal leiomyosarcomas, even when metastases are present.