A CASE OF LEIOMYOSARCOMA OF THE DUODENUM ACCOMPANIED WITH NONROTATION

A case of leiomyosarcoma of the duodenum accompanied with nonrotation was reported. The patient was a 39-year-old man who complained of a mass the size of a child's head in the epigastrium. The upper gastrointestinal series demonstrated moderate lateral displacement of the discending duodenum, and a vertical duodenum that did not cross the midline. Barium enema showed a left-sided colon and entirely right-sided small bowel, indicating nonrotation. On selective celiac angiogram, it was noted that the tumor was nourished by the superior pancreaticoduodenal artery. The tumor showed mottled staining with contrast medium, indicating hypervascularity. Ultrasonography revealed a large mass with a thick echogenic wall and sonolucent center. Operation was performed under the diagnosis of submucosal tumor of the duodenum. At surgery, a large tumor involving the first portion of the duodenum with peritoneal dissemination was identified. To remove the lesion, subtotal gastrectomy was performed. The histologic examination revealed that the tumor was leiomyosarcoma.