Two rare cases of leiomyosarcoma of the small intestine are reported. Case 1 was a 74-year-old female, who had a history of receiving multiple blood transfusions because of recurrent melena for several years. She had been examined several times with gastrointestinal barium studies, gastroscopy, and colonoscopy in other hospitals, but the bleeding focus could not be detected. Mesenteric angiography performed in the department demonstrated a hypervascular tumor with irregular vessels in the small intestine. By angiographic findings, leiomyosarcoma of the small intestine was suspected preoperatively, and segmental resection of the jejunum was performed. Case 2 was a 40-year-old male. he was referred to the hospital, because a solid mass with a cystic part locating behind the pancreatic head was pointed out by US for health check. CT and barium meal study could not detect the origin of the tumor. Angiographically, the tumor was fed by pancreatic arcade and first lumbar artery. At laparotomy, the tumor was found to be a leiomyosarcoma arising from the third portion of the duodenum and growing extraluminally, and partial duodenectomy was performed.
Because leiomyosarcoma of the small intestine frequently grows extraluminally, barium contrast study is often negative. Whereas, angiography can demonstrate the site of the tumor staining and the sourse of bleeding, reflecting the highly vascular nature of this tumor.