Primary leiomyosarcoma of the first metatarsal bone: A case report

D Singh,Dk Mhembelo,T Mmopelwa,R Kumar,Gg Kamau

doi:10.17159/2309-8309/2017/v16n1a6

Abstract

INTRODUCTION: Primary leiomyosarcoma of bone is a rare entity which has never been reported in the foot. We report a case of primary leiomyosarcoma of metatarsal bone. CASE REPORT: A 60-year-old male presented with a history of pain, progressively increasing swelling and a non-healing ulcer over the dorsomedial aspect of his right foot. Plain radiograph showed an osteolytic, destructive lesion of the first metatarsal with involvement of surrounding soft tissue and bones. Magnetic resonance imaging showed a lesion that was hypointense on T1- and heterogeneous on T2-weighted images. Histology of the tumour with immunohistochemistry features aid in making the diagnosis of primary leiomyosarcoma of the first metatarsal bone, which was rare for this location. DISCUSSION: A brief review of the literature is done to determine the epidemiology, radiological and histological features and management of this tumour. CONCLUSION: Primary leiomyosarcoma of bone is a rare tumour and should be kept in the differential diagnosis of primary malignant osteolytic, destructive neoplasms especially in the older age group LEVEL OF EVIDENCE: therapeutic, IV

Highlights

Primary leiomyosarcoma of bone is a rare entity which has never been reported in the foot
Case report: A 60-year-old male presented with a history of pain, progressively increasing swelling and a nonhealing ulcer over the dorsomedial aspect of his right foot
Histology of the tumour with immunohistochemistry features aid in making the diagnosis of primary leiomyosarcoma of the first metatarsal bone, which was rare for this location

Summary

Conclusion

Primary leiomyosarcoma of bone is rare and should be kept in the differential diagnosis of primary malignant osteolytic, destructive neoplasms, especially in the older age group. Vascular leiomyosarcoma of peripheral veins is another rare possibility more common sites are inferior vena cava, pulmonary arteries and iliac veins.[21,22] Histopathology evaluation with immunohistochemistry analysis is helpful in reaching the accurate diagnosis. Treatment is primarily surgical with limited benefit from neoadjuvant and adjuvant therapies. The authors declare that no benefits of any form have been received from a commercial party related directly or indirectly to the subject of this article. The patient was informed that the data would be submitted for publication, to which he gave his consent

Introduction