A Rare Clinical Case Series of Leiomyosarcoma of Bone With Review of Literature

Abstract

Introduction: Leiomyosarcoma is a rare malignant sarcoma which occurs in different anatomic sites including bone with similar histological characteristics but heterogenous clinical behaviour and prognosis. Primary LMS of bone is a rare aggressive sarcoma which presents as a high grade destructive tumour with poor prognosis and limited treatment options. Final diagnosis of LMS includes a combination of histomorphological features along with immunohistochemistry. Due to rarity of disease there is limited understanding of its pathology , prognosis and treatment . Objective: Due to rarity of this disease a case series of primary LMS of bone is prepared to understand its behaviour and management in accordance with the current literature. Material And Methods: 3 cases of primary LMS of Bone is documented in this case series along with history, imaging , diagnosis and treatment. 1] LMS Left Fibula :- A 55 year old male patient reported with pain and partial limitation of motion of the left knee joint. Patient managed with Surgery and Radiotherapy. 2] LMS Right Shoulder :- A 40 year old female patient reported with complaints of lump over right back with associated pain and restriction of joint movements. Patient managed with Surgery, Radiotherapy and Chemotherapy. 3] LMS Right Hip :- A 50 year old male patient reported with lump over right hip with pus discharge. Patient managed with Chemotherapy , Surgery and Radiotherapy . Conclusion: Due to rarity of LMS Bone cases little is known about its clinical behaviour and treatment outcomes. A multidisciplinary approach is needed for the optimal management of the disease. Surgery with a curative intent is the corner stone of treatment of localised disease along with the combination of neoadjuvant or adjuvant chemotherapy and radiotherapy. Further research is needed to identify more effective outcomes.