Key Clinical Message (44/50 words)
This report describes the first case of spindle cell sarcoma (SCS) occurring at the colonic anastomosis after ileocecal resection for colorectal cancer. SCS is rare, and the treatment strategy remains controversial. We report the diagnosis, management, and outcome of an 86-year-old woman with SCS.
KEYWORDS: Primary spindle cell sarcoma, colon cancer, surgery, ileocecal resection, case report
INTRODUCTION (1,638/3,000 words)
Primary spindle cell sarcoma (SCS) is a subtype of mesenchymal sarcoma, a broad term for cancers that arise in connective tissues, such as muscles, bones, cartilage, fat, blood vessels, and tendons. Primary mesenchymal sarcomas of the gastrointestinal system are rare, comprising merely 0.1–3% of all gastrointestinal tumors.1
SCS can occur in almost any part of the body,2 but it is more common in superficial sites, such as the head, neck, and upper and lower limbs.3 Individuals of all ages can be affected, but middle-aged and older adults (50–70 years) are the most common age groups, and men tend to be more affected.4One study reported that abdominal occurrence (133 in 3,299 cases) was a poor prognostic factor compared with occurrence in other parts of the body.2
Various treatment options have been described, including chemotherapy, radiotherapy, and surgery. Surgical resection achieves a better prognosis than non-resection,3 and surgical therapy remains the gold standard for soft tissue sarcomas. However, the importance of lymph node dissection and extensive resection remains controversial.
In this report, we describe a case of SCS that arises at the anastomosis site after ileocecal resection for ascending colon cancer. SCS occurring in the intestinal tract is rare, and this is the first report of SCS occurring at an anastomosis site after colon resection for colorectal cancer.