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

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.