A CASE OF LEIOMYOSARCOMA ARISING IN THE PECTRAL MUSCLE

Abstract

Among tumors of the soft parts, leiomyosarcoma rarely occurs, especially that primary arising in the pectral muscle. We report a 70-year-old man with leiomyosarcoma who had operated on three times for leiomyosarcoma arising in the pectral muscle originating from the smooth muscle of blood vessels. He noticed a subcutaneous nodule with no tenderness in the right precordia. A heterogeneous mass shadow, measuring 20×5mm in diameter, was detected in the right chest wall by US scanning. There were no color changes on the skin. An operation was performed with a diagnosis of locally recurred leiomyosarcoma. The operative procedure was wide spread surgical excision including the surrounded pectral muscle. Histological examination showed spindle-shaped tumor cells in a fascicular pattern in a whirlpool style with round-oval nucleus. Immunohistological analysis showed that the tumor cells were positive for both smooth muscle actin and vimentin but negative for keratin and NSE. Accordingly we diagnosed this case as local recurrence of leimyosaroma. Postoperative course was uneventful. No recurrence or metastasis has occurred as of 4 months after the operation. The patient is closely followed on ambulant basis. Some bibliographical comments are also presented.