Leiomyosarcoma of the vulva: a case report

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Rare Cancers

Background:

• Vulvar leiomyosarcoma (LMS) is a rare malignancy, comprising approximately 1% of primary vulvar tumors and is the most common type of vulvar sarcoma.
• Typically originating from smooth muscles, blood vessels, or ligaments, LMS lacks established treatment algorithms.
• Current management involves tumor excision with clean resection lines, with radiation therapy considered in specific cases.

Observation:

• A case of a 73-year-old patient presenting with pain and a rapidly growing vulvar mass with irregular margins and satellite nodules.
• The patient underwent extensive local excision followed by radiation therapy.

Findings:

• Leiomyosarcoma most frequently occurs in the labia majora, Bartholin gland area, clitoris, and labia minora.
• While often affecting perimenopausal women, LMS has been documented in younger and pregnant individuals.
• Accurate histological diagnosis is crucial for effective management due to macroscopic similarities with other vulvar tumors.

Implications:

• The rarity of vulvar LMS necessitates careful histological evaluation for accurate diagnosis.
• Surgical treatment, emphasizing complete tumor removal with verified clean resection margins, is the cornerstone of management.
• Adjuvant radiation therapy may be considered in select cases, highlighting the need for individualized treatment strategies.