Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2023; 15(5): 992-999
Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.992
Curative resection of leiomyosarcoma of the descending colon with metachronous liver metastasis: A case report
Soo-Hyeon Lee, Sang-Ho Bae, Sang-Cheol Lee, Tae-Sung Ahn, Zisun Kim, Hae-Il Jung
Soo-Hyeon Lee, Sang-Ho Bae, Tae-Sung Ahn, Hae-Il Jung, Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Chungnam, South Korea
Sang-Cheol Lee, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Chungnam, South Korea
Zisun Kim, Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Gyeonggi, South Korea
Author contributions: Jung HI contributed to the design of the case report; Lee SH wrote the draft of the manuscript; Ahn TS and Bae SH performed the operations that led to the pathological diagnosis; Lee SC and Kim Z managed the patient’s condition; Jung HI supervised this study; all authors have read and approved the final manuscript and agree to be held accountable for all aspects of this report.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hae-Il Jung, MD, PhD, Associate Professor, Doctor, Professor, Surgeon, Department of Surgery, Soonchunhyang University Cheonan Hospital, No. 31 Soonchunhyang 6-gil, Dongnam-gu, Cheonan 31151, Chungnam, South Korea.
Received: December 28, 2022
Peer-review started: December 28, 2022
First decision: January 10, 2023
Revised: January 23, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: May 27, 2023

Leiomyosarcoma (LMS) has a poor prognosis and rarely originates from the colon. If resection is possible, surgery is the first treatment most commonly considered. Unfortunately, no standard treatment exists for hepatic metastasis of LMS; although, several treatments, such as chemotherapy, radiotherapy, and surgery, have been used. Subsequently, the management of liver metastases remains controversial.


We present a rare case of metachronous liver metastasis in a patient with LMS originating from the descending colon. A 38-year-old man initially reported abdominal pain and diarrhea over the previous two months. Colonoscopy revealed a 4-cm diameter mass in the descending colon, 40 cm from the anal verge. Computed tomography revealed intussusception of the descending colon due to the 4-cm mass. The patient underwent a left hemicolectomy. Immunohistochemical analysis of the tumor revealed that it was positive for smooth muscle actin and desmin, and negative for cluster of differentiation 34 (CD34), CD117, and discovered on gastrointestinal stromal tumor (GIST)-1, which are characteristic of gastrointestinal LMS. A single liver metastasis developed 11 mo post-operatively; the patient subsequently underwent curative resection thereof. The patient remained disease-free after six cycles of adjuvant chemotherapy (doxorubicin and ifosfamide), and 40 and 52 mo after liver resection and primary surgery, respectively. Similar cases were obtained from a search of Embase, PubMed, MEDLINE, and Google Scholar.


Early diagnosis and surgical resection may be the only potential curative options for liver metastasis of gastrointestinal LMS.

Keywords: Leiomyosarcoma, Colon, Liver metastasis, Surgical resection, Treatment, Case report

Core Tip: Leiomyosarcoma (LMS) rarely originates from the colon; hepatic metastasis of LMS lacks standard treatment. We present a case report of a 38-year-old man who was found to have intussusception in the descending colon due to a 4-cm LMS. The patient underwent a left hemicolectomy, however, a single liver metastasis developed 11 mo after the primary surgery. He underwent curative resection of the metastatic lesion and six cycles of adjuvant chemotherapy. The patient remained disease-free for 52 mo after the primary surgery. An early diagnosis and R0 resection may be the only potential curative approach to liver metastasis of gastrointestinal LMS.