Primary Leiomyosarcoma of Breast Presenting with Metastasis: An Atypical Presentation with Dismal Prognosis

Leiomyosarcoma is an extremely uncommon subtype of breast sarcoma, with <50 cases reported in the English literature till date. Patients usually present at an early stage and follow an indolent course. We reported an unusual case of leiomyosarcoma of breast in a post -menopausal female,presented with right side breast lump and pain right side hip. Histomorphological evaluation and immunohistochemistry confirmed the diagnosis. The patient received palliative radiotherapy 20 Gy in 5 fractions to right iliac bone and was started on chemotherapy comprising of docetaxel and epirubicin. Leiomyosarcoma of breast is known to have local recurrence and hematogenous metastasis, usually 10–15 years after the primary diagnosis. Aggressive behavior of leiomyosarcomas in the form of such a rapidly growing, fungating mass of 15 cm in greatest dimension with hematogenous metastasis at the time of initial presentation, as seen in our case, is extremely unusual.