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Abstract
Leiomyosarcoma is an uncommon soft tissue sarcoma that composed of malignant mesenchymal cells with distinct features of the smooth muscle lineage. Typically affects the uterus and gastrointestinal tract, it can rarely be seen in large blood vessels, lymphatic and glandular duts, the mesentery, the omentum, retroperitoneum, and limbs. Occurrence is particularly rare in the limb region. Retrospective study based on patient records and postoperative pathological histological features. Four patients with limb leiomyosarcoma that were operated between 2016 and 2020 were included, three of them arising in the subcutis of the thigh region and one in cubitus. Extend resection with satisfactory outcomes is reported. Pathological examination showed that masses were composed of a fascicular arrangement of hyperchromatic spindle-shaped cells, characterized by the proliferation of epithelioid cells with eosinophilic cytoplasm for epithelioid leiomyosarcoma. Leiomyosarcomas that arise in the soft tissue, although rare, should be differentiated from other lesions, such as neurilemoma, neurofibroma, liomyoma,lipomyoma, synoviosarcoma, rhabdomyosarcoma, malignant fibrous histiotoma, and malignant neurinoma.
Highlights
Leiomyosarcoma is an uncommon soft tissue sarcoma composed of malignant mesenchymal cells showing distinct features of a smooth muscle lineage
It usually affects the uterus and gastrointestinal tract but that may be found in less common sites including large blood vessels, lymphatic and glandular duts, the mesentery, onmentum, and retroperitoneum as well as the limbs
Preoperative diagnosis of leiomyosarcoma is challenging because of nonspecific symptoms and a rapidly enlarging mass, and it mainly depends on postoperative pathological examination
Summary
Leiomyosarcoma is an uncommon soft tissue sarcoma composed of malignant mesenchymal cells showing distinct features of a smooth muscle lineage. It usually affects the uterus and gastrointestinal tract but that may be found in less common sites including large blood vessels, lymphatic and glandular duts, the mesentery, onmentum, and retroperitoneum as well as the limbs. Leiomyosarcomas of the cubitus and subcutis of the thigh region are very infrequent occurrences. The histological grade, tumor size, and tumor depth are the three major clinical pathologic factors for the prognosis of leiomyosarcoma. Around 90% of leiomyosarcomas are reported to be moderate to high grade [2]. We report four cases of leiomyosarcoma and discuss possible differential diagnoses
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