Primary Cutaneous Leiomyosarcoma of the Gluteal Region: A Rare Case Report and Review of Literature

Abstract

Primary Cutaneous Leiomyosarcoma is an infrequent malignant neoplasm of dermal or subcutaneous smooth muscle origin. This report highlights an unusual presentation of the disease as a painful, progressive gluteal swelling in a fifty-year-old male, initially mismanaged as a benign lesion. The mass was excised twice, with histology reported as a spindle cell neoplasm and treated as benign entity. Recurrence at the same site with progressive enlargement prompted referral to our centre, where our surgeons proceeded with wide local excision. Histopathology with immunohistochemistry confirmed the diagnosis of leiomyosarcoma. The unusual anatomical site, repeated recurrence and diagnostic delay highlight the complexity of this entity. This case highlights the importance of maintaining a high index of suspicion for uncommon presentations and emphasizes the critical role of prudent histopathological assessment for accurate diagnosis. A multidisciplinary approach is needed in guiding an effective management & improving patient outcomes.