Leiomyosarcomatosis involving the duodenum and the subcutaneous tissue

Soft tissue sarcomas include only 0.7% of all malignancies and leiomyosarcomas constitute about 10% of all sarcomas. Very rarely leiomyosarcoma may present as multifocal primaries. We report a 65-year-old patient with multiple subcutaneous nodules. During the investigation period the patient had hematemesis and melena. Upper gastro-intestinal endoscopy was performed and multiple polypoid lesions were discovered in the duodenum. The rest of gastrointestinal system was normal with barium graphies. Biopsies from the subcutaneous nodules and duodenal lesions showed leiomyosarcoma. Although we cannot rule out the possibility of metastases, we strongly consider a multicentric origin since no other metastasis is present and duodenal lesions are also multiple.