Colon Leiomyosarcoma Diagnosed by Pleural Biopsy: A Case Study

Leiomyosarcomas (LMS) are rare tumors of the gastrointestinal (GI) tract with aggressive and poor prognosis. LMS metastasizes primarily to the liver but rarely to the lungs, and has hematogenous spreading from smooth muscle cells of the intestinal wall. Pulmonary LMS is encountered in one of 3000 pulmonary carcinomas. A 60-year male patient was admitted in the department of chest diseases in Meram Medical Faculty at Necmettin Erbakan University, Konya due to dyspnea, cough, fatigue, and weight loss, as well as massive pleural effusion findings on the left. His thoracentesis fluid demonstrated exudate characteristics, and cytological examination revealed lymphocytosis. On thoracic computerized tomography (CT), multiple nodules with irregular contours were observed in mediastinal pleura. Pleural biopsy was compatible with LMS. In primary focus scan, lesions showing increased fluorodeoxyglucose (FDG) involvement in the colon; (SUV max: 34.87-21.08) were seen on positron emission tomography/computed tomography (PET-CT). A 2-cm-polypoid lesion was observed on colonoscopy. Planned for chemotherapy due to the pleural metastasis of colon LMS, the patient died without receiving chemotherapy one month after the rapid impairment in general status. PET-CT is very valuable in the determination of the primary focus and the immunohistochemical examination and diagnosis of this rare malignancy of pleura. The fact that the malignant pleura with poor prognosis is diagnosed earlier will create wide treatment options and be beneficial to clinicians to know such a rare cause of exudative effusion. Based on literature, we are here reporting the case presented with massive pleural effusion due to pleural metastasis of