Imaging Characteristics of Uncommon Case of Jejunal Leiomyosarcomain Middle Aged Women

INTRODUCTION: Primary Malignant small bowel neoplasms are uncommon. Of this Leiomyosarcoma of jejunum is rare with late onset of clinical manifestations and poor prognosis. CASEREPORT: A 40 years middle-aged women presented to our hospital with mass per abdomen, loss of appetite, vomiting and pain abdomen since 1year. Ultrasonography showed a large intraperitoneal solid irregular mass measuring approximately 23x20 cms, which is extending from epigastric to hypogastric region, laterally to bilateral lumbar and iliac fossae displacing adjacent bowel loops with no bowel obstruction. Solid organs were unremarkable. CECT showed mild to moderately enhanced large exophytic mass inseparable from small intestinal bowel loops, however exact site of origin couldn�t be elicited. Provisional diagnosis was small intestinal mesenchymal tumors. Patient underwent explorative laprotomy showing 27x25cms irregular solid mass arising from jejunum with lymph nodes was resected and Histopathological analysis revealed grade 3 leiomyosarcoma. CONCLUSION: A leiomyosarcoma was diagnosed in a hypertensive and diabetic middle-aged women with late onset of clinical manifestations. Radical surgical resection was done with chemo radiation, however it showed poor prognosis with early intraperitoneal metastasis with in 3 months of follow up scan. Advanced multidisciplinary approach of radiological investigations with immunohistochemistry helps in early diagnosis and management.