Surgical Science, 2013, 4, 283-287 http://dx.doi.org/10.4236/ss.2013.45055 Published Online May 2013 (http://www.scirp.org/journal/ss) Epitheloid Leiomyosarcoma of the Jejunum Presenting with Intussusception in a Young Adult Male: A Case Report John O. Obafunwa 1* , Christopher Pritchett 2 , Siva Maikandanathan 2 , Dahiru Adamu Garkuwa 2 1 Department of Pathology and Forensic Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria 2 Department of Surgery, South Tyneside District Hospital, South Shields, UK Email: * joobafunwa@hotmail.com Received December 31, 2012; revised February 1, 2013; accepted February 10, 2013 Copyright © 2013 John O. Obafunwa et al. This is an open access article distributed under the Creative Commons Attribution Li- cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT A 27-year-old male presented with intestinal obstruction due to a jejuno-jejunal intussusception, 23 years after a childhood nasopharyngeal carcinoma. He was successfully treated for the latter by radiotherapy but subsequently required a mandibuloplasty for presumably facial hypoplasia sequel to the radiotherapy. The present intussusception was resected with wide margins revealing a partly haemorrhagic, polypoid and sessile jejunal tumour measuring 7.7 × 3.5 × 2.6 cm. Microscopy with extensive immunohistochemical studies revealed a relatively rare and highly malignant epitheloid leiomyosarcoma arising from the muscularis propria with extension to the mucosa and serosa. No metastases were found and post-operative follow-up has so far been uneventful. The present case of a malignant tumour presenting as an intussusception in a young adult, was unrelated to a childhood malignant tumour in the same patient. The former was successfully treated by a wide excision in support of the advocated surgical approach to adult intussusception. Keywords: Epitheloid Leiomyosarcoma; Intussusception; Surgical Resection 1. Introduction Intussusception with consequent intestinal obstruction is not an uncommon encounter in routine surgical practice and tumours of the small bowel are recognised causes. Usually these tumours are benign, and they include gas- trointestinal stromal tumours (GIST) [1], adenomatous pol- yps and adenomyomas [2,3]. Rare non-neoplastic lesions of the small intestine presenting with intussusception include the inflammatory fibrous polyps also referred to as inflam- matory pseudotumours [4]. Malignant tumours, particularly those of mesenchymal origin presenting with intussuscep- tion, are rarer in the small intestine. These are commonly the gastrointestinal stromal tumours (GISTs) [5-7]. Less com- mon malignant mesenchymal tumours include well dif- ferentiated leiomyosarcomas, malignant schwannomas and undifferentiated sarcomas [6,7]. The present authors report a case of epitheloid leio- myosarcoma (leiomyoblastoma) presenting with intus- susception in a young adult male. The clinicopathologi- cal findings, surgical approach, immunohistochemical stu- dies and prognostic considerations are discussed. 2. Case History A 27-year-old male presented with a 3-day history of vomiting and non-radiating mid-abdominal pain. There was past medical history of a malignant neck lesion at the age of four years, which on biopsy was thought to be Hodgkin’s lymphoma. Subsequent review suggested a diagnosis of rhabdomyosarcoma, but further expert opin- ion was said to have confirmed a diagnosis of nasopha- ryngeal carcinoma. Unfortunately there are no definitive records from the previous hospital and the histopatho- logical slides were not available to the present authors. However, based on the final diagnosis he underwent ra- diotherapy with good response and he apparently had good developmental growth over the years. He under- went mandibuloplasty for facial hypoplasia supposedly for complications due to the radiotherapy. There was no history of abdominal surgery. While presenting on this occasion, there was abdomi- nal tenderness without a palpable mass, and his vital signs were normal. Plain abdominal X-ray showed a distended stomach, but the small bowel appeared normal, and he was managed conservatively. On the third day post-admission * Corresponding author. Copyright © 2013 SciRes. SS