title: Primary pleural leiomyosarcoma with rapid progression and fatal outcome: a case report.
abstract: BACKGROUND
  Leiomyosarcomas are neoplasms of smooth muscles that most commonly arise from the uterus, gastrointestinal tract, or soft tissue. Primary pleural leiomyosarcoma is extremely rare. To the best of our knowledge, only nine cases have been published to date. Because of the rarity of pleural leiomyosarcoma and its similarity (clinical and histological) to other pleural neoplasms, particularly sarcomatous mesothelioma, diagnosis is often difficult.
  
  
  METHODS
  A 58-year-old North African man was admitted with complaints of dyspnea and chest pain to our hospital. Chest computed tomography revealed right pleural effusion and pleural thickening. A transthoracic needle biopsy yielded a diagnosis of leiomyosarcoma, and tumor cells were strongly and uniformly positive for vimentin, a smooth muscle actin at immunohistochemical analysis. A general examination did not show any metastatic lesions in other areas. One month after diagnosis, the tumor grew rapidly, with pulmonary invasion, and therefore he was treated only by palliative care. He died from respiratory failure one month later. Because no organ of origin of the leiomyosarcoma, other than the pleura, was detected, this case was diagnosed as a primary pleural leiomyosarcoma.
  
  
  CONCLUSIONS
  Although leiomyosarcoma originating from the pleura is rare, this entity is increasingly described. The purpose of presenting this case report is to raise awareness among clinicians to consider this clinical entity as a differential diagnosis when a pleural mass is identified.
authors.affiliation: Medical Oncology Department, National Institute of Oncology, Rabat, Morocco. medghiz@hotmail.com.
authors.forename: Ghizlane
authors.initials: G
authors.lastname: Rais
authors.forename: Soundouss
authors.initials: S
authors.lastname: Raissouni
authors.forename: Houda
authors.initials: H
authors.lastname: Mouzount
authors.forename: Meryem
authors.initials: M
authors.lastname: Aitelhaj
authors.forename: Siham
authors.initials: S
authors.lastname: Khoyaali
authors.forename: Fadoi
authors.initials: F
authors.lastname: El Omrani
authors.forename: Hind
authors.initials: H
authors.lastname: Mrabti
authors.forename: Ahmed
authors.initials: A
authors.lastname: Jelthi
authors.forename: Hassan
authors.initials: H
authors.lastname: Errihani