Primary Leiomyosarcoma of Breast Presenting with Metastasis: An Atypical Presentation with Dismal Prognosis

Leiomyosarcoma is an extremely uncommon subtype of breast sarcoma, with <50 cases reported in the English literature till date. Patients usually present at an early stage and follow an indolent course. We reported an unusual case of leiomyosarcoma of breast in a post -menopausal female,presented with right side breast lump and pain right side hip. Histomorphological evaluation and immunohistochemistry confirmed the diagnosis. The patient received palliative radiotherapy 20 Gy in 5 fractions to right iliac bone and was started on chemotherapy comprising of docetaxel and epirubicin. Leiomyosarcoma of breast is known to have local recurrence and hematogenous metastasis, usually 10-15 years after the primary diagnosis. Aggressive behavior of leiomyosarcomas in the form of such a rapidly growing, fungating mass of 15 cm in greatest dimension with hematogenous metastasis at the time of initial presentation, as seen in our case, is extremely unusual.