Case Report
A Case Report of Spindle Cell Neoplasm (Leiomyoma) of Jejunum Presenting as Overt Lower Gastrointestinal Bleeding- A Radiological Perspective
Akhil. M. Kulkarni, Maheshwari M Pujari, Suhasini Vittal Rao and Srinivas S
1Consultant fetal medicine specialist, Davangere Scan centre, Karnataka, India.
2Department of Radiology SSIMS & RC Davangere, Karnataka, India.
3Consultant surgeon, Davangere, Karnataka, India.
2Department of Radiology SSIMS & RC Davangere, Karnataka, India.
3Consultant surgeon, Davangere, Karnataka, India.
*Corresponding author:Suhasini Vittal Rao, Consultant fetal medicine specialist, Davangere scan centre, Davangere, Karnataka, India, E-mail: drsuhasini2010@gmail.com
Copyright: © 2025 Kulkarni AM, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article Information:Submission: 16/06/2025; Accepted: 05/08/2025; Published: 06/08/2025
Abstract
Background: Diagnosing gastrointestinal (GI) bleeding using radiological methods remains challenging, particularly when conventional endoscopic and imaging techniques fail to reveal a clear source. Computed tomography (CT) plays a supportive role by helping to localize the bleeding and identify potential
causes, supplementing other modalities like endoscopy, nuclear scans, and angiography. This report emphasizes the diagnostic utility of multiphase contrast enhanced CT enterography in detecting a rare benign smooth muscle tumor —jejunal leiomyoma—as the source of GI bleeding.
Case Presentation: We present the case of a 50-year-old woman who experienced acute hematochezia. Both upper GI endoscopy and colonoscopy were inconclusive. Multiphase contrast-enhanced CT enterography, performed with neutral contrast, demonstrated a well-defined, enhancing extra luminal mass in the proximal jejunum. Surgical resection followed by histopathological analysis confirmed the mass as a spindle cell tumor, consistent with a leiomyoma.
Conclusion: This case highlights the value of multiphase CT enterography in pinpointing bleeding sources and characterizing bowel lesions, thereby guiding surgical decisions. It also brings attention to a rare manifestation of small bowel leiomyoma presenting with overt lower GI bleeding.
Case Presentation: We present the case of a 50-year-old woman who experienced acute hematochezia. Both upper GI endoscopy and colonoscopy were inconclusive. Multiphase contrast-enhanced CT enterography, performed with neutral contrast, demonstrated a well-defined, enhancing extra luminal mass in the proximal jejunum. Surgical resection followed by histopathological analysis confirmed the mass as a spindle cell tumor, consistent with a leiomyoma.
Conclusion: This case highlights the value of multiphase CT enterography in pinpointing bleeding sources and characterizing bowel lesions, thereby guiding surgical decisions. It also brings attention to a rare manifestation of small bowel leiomyoma presenting with overt lower GI bleeding.
Keywords: Lower gastrointestinal (GI) bleeding, Computed Tomography Enterography (CTE), Upper gastrointestinal (UGI) endoscopy.