084 A case of primary subcutaneous leiomyosarcoma of the lower extremity

Subcutaneous leiomyosarcomas (LMS) are a rare smooth muscle neoplasm representing only 2-3% of all superficial soft tissue sarcomas. The purpose this study was to provide clinical case that focuses on proper management and follow-up care due the high rate recurrence. A middle-aged Caucasian man with past medical history chronic obstructive pulmonary disease referred for suspicious skin lesion measuring 1.4 cm his right anteriolateral thigh increasing pain. patient denied medications except 325mg acetaminophen. any associated systemic findings. In social history, reports an 88-pack year smoking. area around anesthesized 1ml 2% xylocaine epinephrine subsequent 8 mm shave biopsy taken by electrodessication curettage (ED&C) technique. section showed extending from epidermis deep dermis. highly atypical spindle cells pleomorphic nuclei mitotic activity. tumor were arranged in long short fascicles. Positive staining present actin, vimentin, desmin. Histology conjunction immunostaining supported grade I LMS tumor. Right femur MRI contrast enhancing anterolateral distal into subcutaneous tissues thickening 2.6 x 3.0 cm. CT imaging studies chest, abdomen, pelvis no evidence metastatic disease. Patient underwent wide local excision (WLE) lower extremity under general anesthesia circumscribed mass obtained. Pathology confirmed 1cm negative margins. At one-week follow up, incision appeared be healing well scheduled 3 month up. Due recurrence 8-40% LMS, close surveillance is recommended at 3-6 intervals first 2 years as long-term thereafter. As strongest predictor adequacy margins, we recommend margins adequate outcomes.