IMAGE OF THE MONTH| Volume 42, ISSUE 2, P109, February 2020

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Leiomyosarcoma Manifesting With Bowel Obstruction

Published:February 14, 2019DOI:
      A 50-year-old woman presented to the emergency department with symptoms of large bowel obstruction and abnormal vaginal bleeding. She was found to have an exophytic abdominal mass (Figure 1). She noticed the mass growing 5 years before presentation. Imaging revealed a large (33 × 15 cm) abdominal mass, with a smaller (22 × 23 cm) associated pedunculated mass, and the transverse colon herniating through a fascial defect (Figure 2). The hernia sac contained ascites fluid and bowel. She underwent an abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and hernia repair. She did not require a bowel resection. The uterus had been replaced with a leiomyosarcoma with a serosal metastasis, with a pedunculated mass that was also leiomyosarcoma. Postoperative imaging revealed lung lesions of unknown significance. She is now undergoing chemotherapy.
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