Pulmonary Leiomyosarcoma: A Diagnostic Challenge

Primary pulmonary leiomyosarcoma (PPL) is an extremely rare form of lung cancer, accounting for only a small fraction of all lung cancer cases. We describe a middle-aged woman who came to the hospital with cough and breathlessness, and imaging revealed multiple lung masses. A biopsy showed spindle-shaped tumor cells positive for smooth muscle markers, confirming leiomyosarcoma. She was treated with combination chemotherapy followed by oral pazopanib, showing good clinical and radiological improvement. This case highlights how rare and difficult to diagnose this tumor can be and the importance of tissue diagnosis in guiding effective treatment.