A leiomyosarcoma of the rectum is a rare disease, and cases of a recurrence are even more rare. Reported is the case of a patient who, in 1987, underwent a per sacral resection of a rectal tumor which was diagnosed as leiomyosarcoma. In 1987, after symptoms that showed that the patient's feces had become narrower, a recurrence of this tumor was diagnosed, so that the patient again underwent an abdominoperineal rectomy. The postoperative course has been good. Details of this disease still remain unclear. In Japan, there have been only 10 such cases of a recurrence reported. Of these, a liver metastasis and a localized recurrence are the most common. Long term follow-ups are considered necessary.
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