A neglected giant subcutaneous leiomyosarcoma of the shoulder: a case report

L. Palla, P. Gentile, C. Cannatà, P. Ascenzi, O. Buonomo*, V. Cervelli

Department of Plastic and Reconstructive Surgery; and *Department of Surgery, University of Study, “TorVergata”, Rome (Italy)

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• Plastic Surgery

Superficial leiomyosarcoma is an exceeding uncommon malignant tumor, which can be located either cutaneous or subcutaneous tissues. It may occur anywhere in the body, but there is a predilection for the thighs. The distinction between cutaneous or subcutaneous, increased mass size (>5 cm) and depth are considered to have worst prognosis in terms of recurrence and metastasis.
We report a rare case of an 81-year-old woman, presented with a 20-cm leiomyosarcoma of the shoulder. The patient reported that the mass was completely asymptomatic and its growth was slow. A CT study showed a lesion closely apposed to the head of the humerus and revealed no a clear relationship with the surrounding muscles. There was no regional lymphadenopathy or the evidence of metastatic disease.
After tumor resection, a large skin and soft-tissue defect was remained and the repair was performed by myocutaneous rotational free flap of latissimus dorsi.
The conclusion of the histological analysis was: subcutaneous leiomyosarcoma pT2 – grade 1+ (NCI system).
The delayed diagnosis and the surgical treatment and giant size of soft tissue leiomyosarcoma may adversely affect the final result.

Corresponding Author: Palla Ludovico, MD; e-mail: ludovicopalla@hotmail.com

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