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An unusual cause of upper gastrointestinal bleeding and small bowel obstruction
An unusual cause of upper gastrointestinal bleeding and small bowel obstruction
Maria Pia Costa Santos, Alexandre Ferreira, Vera Silveira, Luísa Glória, Marília Cravo
A 58-year-old black female, born in Angola, presented with melena, vomiting and a 7-year history of a right thigh mass that progressively increased in size. Her laboratory tests revealed iron deficiency anemia (hemoglobin 4.4g/dL). Computed tomography showed a large solid lesion in the right thigh, multiple smaller lesions in the lungs, pancreas and uterus, focal thickness of the small bowel wall and jejunal intussusception. Upper gastrointestinal endoscopy revealed multiple ulcerative lesions with elevated edges throughout the second and third portions of the duodenum, with 10-20 millimeters, without hemorrhagic stigmata. The histology of the duodenal and thigh lesions revealed a leiomyosarcoma.
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