LEIOMYOSARCOMA OF THE ANAL CANAL: ABOUT ONE CASE REPORT AND REVIEW OF THE LITERATURE.

K.Gharbi , M.A.Lkousse , Y.Ismail , J.Atmani , A.Elfarouki ,
A.Ait Errami , S.Oubaha , Z.Samlani , K.Krati
Gastroenterology service, Hospital Mohammed VI Marrakech Morocco

Page no. 5-9

Introduction:The leiomyosarcoma of the anal canal is a very rare tumor with poor prognosis. Its diagnosis without immunohistochemistry is impossible and its management is not yet clear. We report one more case and a review of the literature. Case report: A 65-year-old woman consulted in October 2018 for anal pain and a rectal syndrome that had been evolving for the last year, without  rectal bleeding, nor  transit disorder;  but with the impairment of general conditions.  The digital rectal assessment , which was painful, perceived a non-stenotising , circumferential tumor process of the anal canal, of stony consistency with sphincteric hypotonia. At the rectoscopy, the anal tumor was circumferential polyploid, neoplastic appearance whose biopsy with immunohistochemical study concluded to an anal leiomyosarcoma. In the extension assessment, pelvic MRI; and pelvic abdominal  and thoracic CT-scan  did not reveal metastases. An abdominopelvic amputation was performed without incident and with good postoperative progress. Conclusion:  The frequency of leiomyosarcomas of the anal canal is extremely low and only a few cases have been reported. The confirmation of the diagnosis is by biopsy and immunohistochemistry. The surgery suggested in the literature is an abdominoperineal amputation (PAA), made in our case with good results.
Key words: anal leiomyosarcoma, immunohistochemistry, abdominoperineal amputation.