Abstract
A 21-year-old man, who had been treated for congenital dilatation of the bile duct 13 years previously, presented with an
acute abdomen. The physical examination suggested peritonitis, and an emergent laparotomy was performed. A perforation
was foundin the jejunum approximately 100 cm distal to the ligament of Treitz, followed by resection of a 60-cm jejunal
segment. No tumorous lesions were found during the operation, and the resected jejunal segment showed only focal
myxomatous thickening of the serosa. Despite intensive therapy, he died of uncontrollable septic shock 2 days after the
operation. Unexpectedly, however, histological examination revealed a liposarcoma, showing an unclassifiable histology.
From the distribution of the lesion and the histological findings, it is thought that a primary lesion was somewhere else,
covered by severe adhesions due to the previous operation, and that the tumor cells spreading from it could have caused the
jejunal perforation through vascular involvement. Although extremely rare, liposarcomas in the abdomen can cause intestinal
perforation. It is important for both clinicians andpathologists to carefully investigate the cause of an unusual clinical
presentation such as intestinal perforation.
Citation
ID:
183659
Ref Key:
horiguchi2003sarcomaa