Gemcitabine-sirolimus synergy associated thrombotic microangiopathy in a renal transplant recipient with mesenteric leiomyosarcoma: A case report

BACKGROUND Mesenteric leiomyosarcoma, a rare tumor originating from the smooth muscle of the mesentery, that may require treatment with gemcitabine based chemotherapy in advanced stages. Gemcitabine usage has been associated with the development of thrombotic microangiopathy, a risk which can be increased by concurrent use of sirolimus. CASE SUMMARY We present the case of a young Caucasian woman with a renal transplant who developed an aggressive leiomyosarcoma. While on gemcitabine, she was not