LEIOMYOSARCOMA OF SMALL INTESTINE PRESENTING AS FEVER OF UNKNOWN ORIGIN DUE TO SPONTANEOUS PERFORATION

We report a patient with a jejunal leiomyosarcomawho presented with fever of unknownorigin. Resection of the tumour resulted inresolution of his symptoms.Jejunal leiomyosarcoma is a rare tumour consistingThe commonest site for these gastrointestinal stromal tumours is stomach (39) followed by small intestine (32), rectum (10), large intestine (5), others (mesentery, omental, oesophagus, diaphragm), intestine unspecified (5).4 In the small intestine it is commonest in the jejunum followed by ileum, duodenum and Meckels diverticulum Patients with thisof smooth muscle cells. tumour generally present with vague symptomssuch as abdominal pain, chronic anaemia, ordiarrhoea and because of this and the lowsensitivity of most diagnostic studies - forexample, enteroclysis, computed tomography,and echography - jejunal leiomyosarcoma isnotoriously difficult to diagnose at an early stage. Histologically, differential diagnosis betweenleiomyoma and leiomyosarcoma is not clear cut,as it is based on a number of differentiatingfeatures with a wide overlap. The tumourtypically spreads by direct invasion and haematogenouslyto the liver, lungs, and bone. Theonly proved treatment is resection, with a fiveyear survival of 40- 60per cent.