Ileal leiomyosarcoma presenting with intussusception

Intussusception is a rare cause of small bowel obstruction in adults, up to 30% of cases are caused by small bowel malignancy. Intestinal leiomyosarcoma is an extremely rare malignant mesenchymal tumour. An 80-year-old male presented with small bowel obstruction. Abdominal ultrasonography and a subsequent CT scan showed small bowel obstruction due to ileo-ileal intussusception. The patient underwent an emergency exploratory laparotomy, which confirmed prior findings on imaging. The affected segment of the ileum was resected and a primary entero-enteral anastomosis was created. Histopathological analysis revealed a 4.8 cm leiomyosarcoma. The patient remains without evidence of disease 12 months after initial presentation. Radical surgical resection remains the treatment of choice for leiomyosarcoma, with no convincing evidence supporting adjuvant treatment. Tumours smaller than 5 cm appear to have a more favourable prognosis.