Primary leiomyosarcoma of the first metatarsal bone: A case report

Abstract

A 60-year-old male presented with nine-month history of pain and progressively increasing swelling over the dorsomedial aspect of the right foot. It started as a small painful swelling over the dorsum of the foot. The patient developed a non-healing fungating ulcer at the biopsy site during the course of disease (Figures 1a and b). There was no history of trauma, fever or discharging sinus, and no history of any other swelling in the body. There was no history of radiation exposure. The patient was non-diabetic and did not present with any other systemic ailment. On examination, a diffuse, hard swelling about 10×15 cm was present over the dorsomedial aspect of the right foot. A fungating ulcer, about 4×4 cm in size, was present over the swelling. There was full range of motion of the ankle. Examination of the chest and abdomen was normal.Plain radiograph of the foot showed a poorly defined lytic lesion with complete destruction of the first metatarsal bone extending into the surrounding tissues, second metatarsal, medial and middle cuneiform (Figure 2). AbstractIntroduction: 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.

Primary leiomyosarcoma of the distal tibia: A case report

“…Definitive diagnosis is achieved via pathology and immunochemistry staining. Immunochemistry of smooth muscle actin (SMA), desmin, or vimentin, is an objective marker of smooth muscle origin [5] , [6] , [7] , [8] .…”

Leiomiosarcoma primario de hueso en fémur distal metastásico a clavícula. Reporte de un caso

“…Aunque no es muy frecuente, se han reportado casos en los huesos craneofaciales, el radio, la clavícula, el peroné, la pelvis, las falanges, los metatarsianos, y las vertebras. 1,5,[8][9][10][11]14 Los síntomas suelen ser inespecíficos y de aparición insidiosa; sin embargo, en algunos estudios 5,8,11 se ha identificado el dolor como síntoma principal, lo que es concordante con el caso descrito.…”

“…[1][2][3] Su presentación ósea es rara; en la literatura, la información respecto al LMS intraóseo es escasa, y la mayoría corresponde a reportes de caso. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Se presenta el caso de una paciente con un LMS primario óseo en fémur distal izquierdo primario, tratado quirúrgicamente y con quimioterapia, en quien posteriormente, durante el seguimiento, se identificó una lesión metastásica en clavícula con fractura patológica manejada con resección quirúrgica.…”

Primary leiomyosarcoma of the distal fibula: A case report and review of the literature

“…On the other hand, low-grade tumors exhibit a geographic pattern of bone destruction with in a sclerotic rim, a thing that can simulate a benign process. 8 , 30 …”

“…However, chemotherapy should be considered in case of a diffuse metastatic disease to the lungs or large pelvic masses with neurovascular involvement that preclude safe resection. 29 , 30 Few reports in the literature have used chemotherapy as a way to debulk the tumor in order to facilitate the surgical excision. The indications for radiotherapy are on the other hand controversial, this includes mainly the cases in which a contaminated resection bed was left over or in which a wide resection cannot be carried on.…”