Abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation: a case report

Lymphangioleiomyomatosis (LAM) is a rare, low-grade malignant condition that typically affects women of childbearing age and primarily involves the lungs. While cases involving males and affecting the gastrointestinal tract are exceedingly uncommon. This report discusses an unusual case of abdominal...

Full description

Saved in:
Bibliographic Details
Main Authors: Ying Zi, Yuchen Shi, Rongjie Shi
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1420414/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850251727953985536
author Ying Zi
Yuchen Shi
Rongjie Shi
author_facet Ying Zi
Yuchen Shi
Rongjie Shi
author_sort Ying Zi
collection DOAJ
description Lymphangioleiomyomatosis (LAM) is a rare, low-grade malignant condition that typically affects women of childbearing age and primarily involves the lungs. While cases involving males and affecting the gastrointestinal tract are exceedingly uncommon. This report discusses an unusual case of abdominal LAM in a male patient with gastrointestinal hemorrhage. The patient, a 70-year-old man, had been experiencing recurrent abdominal pain, occasional black stools, dizziness, and fatigue for over a month before being admitted to the hospital. Diagnostic electronic gastroscopy identified ulcers in the gastric and duodenal bulb with hemorrhage. An abdominal CT scan revealed multiple cystic foci in the retroperitoneum and mesentery, but no masses were found. Despite receiving medical treatment, the patient continued to have black stools and eventually underwent laparoscopic distal subtotal gastrectomy. The pathological results of the excised distal gastric specimens showed LAM-like lesions in the submucosal layer of the pylorus, mesentery of the side of the lesser curvature of the stomach, and small intestine, leading to a diagnosis of abdominal LAM. However, even after the surgery, the patient still experienced recurrent black stools and developed new symptoms of chest tightness and shortness of breath. A follow-up chest CT revealed bilateral pleural effusion and multiple lung cysts, indicating a worsening condition. The patient was then prescribed oral Sirolimus, which resulted in an improvement in symptoms, including black stool, chest tightness, and shortness of breath. This case report provides a detailed account of the progression of an unusual gastrointestinal LAM case and suggests that a combination of surgery and Sirolimus may be effective in managing the condition.
format Article
id doaj-art-6c8d5aaa4cd84b8aa02c138c4e69e8f4
institution OA Journals
issn 2296-858X
language English
publishDate 2024-12-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-6c8d5aaa4cd84b8aa02c138c4e69e8f42025-08-20T01:57:49ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-12-011110.3389/fmed.2024.14204141420414Abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation: a case reportYing Zi0Yuchen Shi1Rongjie Shi2The First Affiliated Hospital of Dali University, Dali, Yunnan, ChinaThe First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Dali University, Dali, Yunnan, ChinaLymphangioleiomyomatosis (LAM) is a rare, low-grade malignant condition that typically affects women of childbearing age and primarily involves the lungs. While cases involving males and affecting the gastrointestinal tract are exceedingly uncommon. This report discusses an unusual case of abdominal LAM in a male patient with gastrointestinal hemorrhage. The patient, a 70-year-old man, had been experiencing recurrent abdominal pain, occasional black stools, dizziness, and fatigue for over a month before being admitted to the hospital. Diagnostic electronic gastroscopy identified ulcers in the gastric and duodenal bulb with hemorrhage. An abdominal CT scan revealed multiple cystic foci in the retroperitoneum and mesentery, but no masses were found. Despite receiving medical treatment, the patient continued to have black stools and eventually underwent laparoscopic distal subtotal gastrectomy. The pathological results of the excised distal gastric specimens showed LAM-like lesions in the submucosal layer of the pylorus, mesentery of the side of the lesser curvature of the stomach, and small intestine, leading to a diagnosis of abdominal LAM. However, even after the surgery, the patient still experienced recurrent black stools and developed new symptoms of chest tightness and shortness of breath. A follow-up chest CT revealed bilateral pleural effusion and multiple lung cysts, indicating a worsening condition. The patient was then prescribed oral Sirolimus, which resulted in an improvement in symptoms, including black stool, chest tightness, and shortness of breath. This case report provides a detailed account of the progression of an unusual gastrointestinal LAM case and suggests that a combination of surgery and Sirolimus may be effective in managing the condition.https://www.frontiersin.org/articles/10.3389/fmed.2024.1420414/fulllymphangioleiomyomatosisgastrointestinal hemorrhageabdomenmalecase report
spellingShingle Ying Zi
Yuchen Shi
Rongjie Shi
Abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation: a case report
Frontiers in Medicine
lymphangioleiomyomatosis
gastrointestinal hemorrhage
abdomen
male
case report
title Abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation: a case report
title_full Abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation: a case report
title_fullStr Abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation: a case report
title_full_unstemmed Abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation: a case report
title_short Abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation: a case report
title_sort abdominal lymphangioleiomyomatosis in a man presenting with gastrointestinal hemorrhage as the first manifestation a case report
topic lymphangioleiomyomatosis
gastrointestinal hemorrhage
abdomen
male
case report
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1420414/full
work_keys_str_mv AT yingzi abdominallymphangioleiomyomatosisinamanpresentingwithgastrointestinalhemorrhageasthefirstmanifestationacasereport
AT yuchenshi abdominallymphangioleiomyomatosisinamanpresentingwithgastrointestinalhemorrhageasthefirstmanifestationacasereport
AT rongjieshi abdominallymphangioleiomyomatosisinamanpresentingwithgastrointestinalhemorrhageasthefirstmanifestationacasereport