Leiomyosarcoma (LMS) areis a rare tumors of the small intestine, which arises from themusculalris mucosa or muscularis propria. The most common site of LMS occurrence in theComment [A1]: The definite article “the” is used
to denote specificity. Here, “the” is required as aspecific organ is being referred to.

small intestine is the jejunum, followed by the ileum and then duodenum. The Its common
presentations manifestations include abdominal mass, abdominal pain, and or overt
gastrointestinal bleeding. They LMS are mainly seen occurs in the 6th decade of life, withslight male preponderance.

The Ppreoperative diagnosis of small intestinal tumors is difficult, especially in terms ofdifferentiating between benign and malignant tumors. For LMS in small intestine, A recent
review of literature review revealed that computed tomography (CT)- and magnetic
resonance (MRI)- enterography and enteroclysis are good optionsmodalities for theassessment of LMS in the small intestine. Cases of sSuperficial lesions, which can be missedby both CT and MRI imaging, can however be detected by water capsule endoscopy, with adetection rate of around approximately 80%.

Histologically, LMS resembles like gastrointestinal stromal tumorGIST,; however, they are itis negative for CD117 and CD34 negative by immunohistochemistry and positive for smoothmuscle antigen actin (SMA) and desmin on immunohistochemistry. When the size of LMS
these tumors are is more than 5 cm, they it commonly spreads hematogenously to the liver(65%), other gastrointestinalGI organs (15%), and the lungs (4%). It also has the capability tocan also spread via the lymphatics system (13%) or via peritoneal route (18%). The only
effective treatment for LMS in the small intestine LMS is surgery. The primary tumor should
be excised radically, including a with wide resection of the mesentry. Response The responseof LMS to chemotherapy is doubtfulunknown, and there is no role for radiotherapy does notplay a role in treatment. Therefore, if possible, metastasectomy, if possible, should beAll material in this document is the intellectual property of Crimson Interactive Pvt. Ltd. The use of informationand content in this document in whole or in part is forbidden unless express permission has been given inwriting by Crimson Interactive Pvt. Ltd.

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Comment [A2]: A nonrestrictive clause is aclause that adds additional or nonessential
information to a sentence. Such clauses are usuallyseparated by commas. Here, as the clause provides
additional information about detection of superficiallesions, it is separated by a comma.

Comment [A3]: In general, terms that are used
only once in the manuscript need not be abbreviated.

considered. Large phase II and III studies trials involving the combination of combining
docetaxel and gemcitabine have reported yielded impressive response rates for in LMSs
(mostly of uterine origin). However, some studies others were have not been able to confirm
the efficacy of this combination. Recently, trabectedin showed response rates of up to 56%
for in LMSs, and it has appeared to be especially particularly useful against in far-advanced
and metastatic LMSs after failure of the combination of anthracyclines and ifosfamide.

All material in this document is the intellectual property of Crimson Interactive Pvt. Ltd. The use of informationand content in this document in whole or in part is forbidden unless express permission has been given inwriting by Crimson Interactive Pvt. Ltd.

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