Rare Metastasis of Cutaneous Leiomyosarcoma to the Inguinal Region: Case report and Literature review

Asad Riaz 1, *, Abdul Muhymin Alam Khattak 1, Bissma Laraib 1, Muhammad Kinwan Khan 2, Waqar Hussain 3, Asad Ur Rehman 4, Tauseef Hamid 5, Muhammad Moen 6, Attal Khan 6, Behram Khalid 7, Irfan Ullah Mashwani 8 and Khan Ifrah Shahid 9

1 Department of General Surgery, Ayub Teaching Hospital, Abbottabad, Pakistan.
2 Department of Community Medicine, Northwest School of Medicine, Peshawar, Pakistan.
3 Medical Officer at Medical Emergency Resilience Force (MERF) NGO, Peshawar, Pakistan.
4 Department of General Medicine, Mardan Medical Complex, Mardan, Pakistan.
5 Department of General Medicine, Saidu Group of Teaching Hospitals, Swat, Pakistan.
6 Department of General Medicine, Ayub Teaching Hospital, Abbottabad, Pakistan.
7 Department of General Medicine, Peshawar General Hospital, Peshawar, Pakistan.
8 Department of General Medicine, Shahid Hussain Orthopedic and General Hospital, Lower Dir, Pakistan.
9 Department of Physiology, Abbottabad International Medical College, Abbottabad, Pakistan. 
 
Case Study
World Journal of Advanced Research and Reviews, 2024, 23(02), 204–210
Article DOI: 10.30574/wjarr.2024.23.2.2304
 
Publication history: 
Received on 20 June 2024; revised on 31 July 2024; accepted on 02 August 2024
 
Abstract: 
Introduction: Cutaneous leiomyosarcoma (CLM) is a rare malignancy arising from smooth muscle cells in the skin. It constitutes 2%-3% of all cutaneous soft tissue sarcomas and is known for its propensity for local recurrence and distant metastasis. Common metastatic sites include the lungs, liver, and brain. Diagnosis involves clinical examination and histopathological analysis, while management typically involves surgical excision, with adjunctive therapies like radiation and chemotherapy often considered due to its aggressive nature. Metastasis rates are reported as 12% for dermal and 51% for subcutaneous CLM.
Case Report: A 40-year-old female with a history of excised leiomyosarcoma on the right buttock presented with a large, painful mass in the right inguinal region. Imaging revealed a substantial subcutaneous mass with significant local invasion and inguinal lymphadenopathy. Histopathological examination confirmed metastatic leiomyosarcoma. The patient showed anemia and elevated white blood cell count.
Literature Review: Various cases reveal that CLM typically presents as nodular masses, primarily managed by surgical excision. Metastasis is rare but can occur, particularly in subcutaneous tumors. Inguinal region metastasis is highly unusual, with most cases showing spread to distant organs or regional lymph nodes. Imaging and histopathological findings are crucial for diagnosis.
Discussion: CLM, while less metastatic compared to other sarcomas, requires vigilant monitoring due to its potential for local recurrence and distant spread. Metastasis to the inguinal region is exceptionally rare, highlighting the need for ongoing research to better understand such anomalies.
Conclusion: CLM generally has a better prognosis than other sarcomas, but early detection of recurrence and metastasis is crucial. The rare occurrence of inguinal region metastasis emphasizes the importance of comprehensive surveillance and further research to understand this phenomenon better.
 
Keywords: 
Cutaneous leiomyosarcoma; Metastatic leiomyosarcoma; Inguinal region metastasis; Soft tissue sarcoma; Skin cancer; Leiomyosarcoma treatment; Surgical excision; Radiation therapy; Chemotherapy; Metastasis;
 
Full text article in PDF: 
Share this