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直肠平滑肌肉瘤少见,根治性切除5年生存率为20％左右。我们遇到一例直肠平滑肌肉瘤于10年内复发4次仍存活,现将该例之误诊原因及治疗经过分析如下。男,56岁。因排尿不畅,伴有直肠内胀痛4个月,肛门指诊:“前列腺肥大”,入院手术中见前列腺大小正常,于膀胱直肠间见4×3cm大小的肿物连于直肠,将肿物摘除,病理报告为直肠高分化平滑肌肉瘤。术后17个月,又因腹胀5天行肛诊检查,距肛缘3cm,5～7点处(胸膝位)触及2.5×2cm大小的肿物,突入肠腔,活动差,指套无血迹。手术中见肿瘤位于粘膜下,边界清,质硬,局部切除后病理报告为直肠高分化平滑肌肉瘤。出院后6个月,患者出现大便变细,偶带鲜血,并伴肛
Rectal leiomyosarcoma is rare and the 5-year survival rate for radical resection is about 20%. We encountered one case of rectal leiomyosarcoma recurring 4 times within 10 years and still survived. The misdiagnosis causes and treatment of this case are analyzed as follows. Male, 56 years old. Due to poor urination, associated with rectal pain for 4 months, anal examination: “prostatic hypertrophy”, normal size of the prostate seen during hospitalization, 4 × 3cm in the bladder rectum, the size of the tumor connected to the rectum, will be swollen The object was removed and the pathology report was rectal highly differentiated leiomyosarcoma. 17 months after operation, due to abdominal distension for 5 days, anal examination was performed 3 cm from the anal verge, and 5 to 7 points (chest-knee position) touched a 2.5×2 cm-sized tumor, which broke into the intestine and had poor activity. Blood traces. In the operation, the tumor was located in the submucosa, the border was clear, and the quality was hard. After local resection, the pathology report was rectal highly differentiated leiomyosarcoma. Six months after discharge, the patient became thinner, occasionally with blood, and anal