Leiomyosarcoma Presenting as a Recurrent Hematoma of the Deltoid Region. a Case Report

LEIOMYOSARCOMA PRESENTING AS A RECURRENT HEMATOMA OF THE DELTOID REGION (Abstract): Leiomyosarcoma is a rare cancer of smooth muscle. The prognosis depends on the patient's age and the size, histologic grade and stage of the tumor. CASE REPORT: The case of a 63year-old man diagnosed with a leiomyosarcoma of the deltoid region is reported. The patient was previously admitted twice in our surgical unit with a large recurrent posttraumatic hematoma of the right deltoid region which was incised and drained. One month later the patient was readmitted under the suspicion of malignancy. Following the large excision of the lesion, pathology and immunohistochemistry report showed a poorly differentiated leiomyosarcoma. One year later the recurrency of the tumour in the upper arm and axillary region imposed a large excision of the tumour of the upper arm and the axillary tumour, followed by a latissimus dorsi miocutaneous flap reconstruction. 4 months later multiple pulmonary metastases were documented at chest X-ray and chemotherapy with doxorubicine was commenced. A new axillary recurrence occured 9 months later and was resected with clear margins followed by radiotherapy. In conclusion, the natural history and clinical picture of leiomyosarcoma may lead to diagnosis delay, poor local control of the disease with multiple recurrences and repeated surgery.