High Grade Leiomyosarcoma Mimicking a Recurrent Angiomyxoma in the Perineum.
Perineal leiomyosarcoma is an extremely rare and aggressive cancer with a high metastatic potential and no defined standard treatment. There are only a few (six) reported cases in the literature. We report the case of a 67-year-old woman with a perineal leiomyosarcoma arising at the same site of a previously resected superficial angiomyxoma. Initially, she was treated for a presumptive recurrence of angiomyxoma. As she did not respond to medical therapy, she underwent repeat surgical excision. Pathology revealed a high grade leiomyosarcoma, histologically strikingly distinct from the initial diagnosis. She received adjuvant local radiation therapy, and remains without evidence of recurrent disease 36 months after completion of all therapy. This is the first reported case of a high grade perineal leiomyosarcoma originating at the same site as a resected benign superficial angiomyxoma. Our case emphasizes the necessity of a prompt histological diagnosis in cases of presumed recurrent perineal angiomyxoma.
Department of Medical and Surgical Gynecology, Mayo Clinic Florida , Jacksonville, FL, USA.
Neha
N
Sood
Department of Medicine, Mayo Clinic Florida , Jacksonville, FL, USA.
Abhisek
A
Swaika
Department of Obstetrics and Gynecology, Flushing Hospital Medical Center , New York City, NY, USA.
Bashar
B
Hanooshi
Department of Plastic Surgery, Mayo Clinic Florida , Jacksonville, FL, USA.
James
J
Waldorf
Department of Radiation Oncology, Mayo Clinic Florida , Jacksonville, FL, USA.
Jennifer
J
Peterson
Department of Pathology, Mayo Clinic Florida , Jacksonville, FL, USA.
Kevin
K
Wu
Department of Medicine, Mayo Clinic Florida , Jacksonville, FL, USA.
Steven
S
Attia
Department of Medical and Surgical Gynecology, Mayo Clinic Florida , Jacksonville, FL, USA.
Tri A
TA
Dinh
Leiomyosarcoma; angiomyxoma; perineum