Primary cutaneous Leiomyosarcoma on the left iliac region: A rare case report from Syria

INTRODUCTION: and importance: Leiomyosarcoma is a rare aggressive soft-tissue malignancy typically originating from embryonic mesoderm or mesenchymal cell lines in smooth muscles. Leiomyosarcoma of the skin is termed as “Dermal Leiomyosarcoma”, and is categorized into two subdivisions; superficial cutaneous and deep subcutaneous. Both types begin either as primary lesions or metastatic lesions from distant sites. CASE PRESENTATION: We report the case of a 60-year-old male patient with Primary Cutaneous Leiomyosarcoma (PCL) located in the left iliac region. His history is insignificant and he has no family or genetic history of leiomyosarcoma. The lesion was itchy without any other symptoms and existed 20 years before our evaluation. A biopsy from the nodule was performed and sent to the pathology department, where the section was stained with smooth muscle actin stain (SMA) and the result was positive. We referred the patient to a surgeon to excise the nodule. The lesion was excised with a 3cm safety margin, the eradication includes also the of the major iliac muscle. After one year of follow-up there was no metastasis nor recurrence. CONCLUSION: Primary Cutaneous Leiomyosarcoma is a very rare malignancy and it is hard to diagnose without biopsy and pathological examination.