Extremely rare case of leimyosarcoma of the thigh!!
Leiomyosarcomas are soft tissue malignancies originating from smooth muscle often found in the uterus and digestive tract. Leiomyosarcomas develop at the level of the thigh are less frequent because the muscles of this region are striated muscles. This patient presented a leiomyosarcoma of the right thigh 3 years after a physical trauma, by direct shock, followed by a hematoma. The cause-and-effect relationship is controversial but very likely. Studies as well as case reports have connected soft tissue tumors to events of physical trauma. There is mounting evidence of inflammation as both an initiator and promotor of tumorigenesis, as well progression. Moreover, as the physiological response of tissue repair and regeneration is mediated through inflammation, it is not unlikely that physical injury may cause and/or contribute to tumor initiation, promotion and/or progression, not least when the subsequent inflammation becomes chronic. The patient presented to the emergency department at an extremely late stage, with a syndrome of tumor lysis, and malignant hyper-calcemia due to bone demineralization caused by the tumor. Treatment consists of amputation and can only be performed if the patient is biologically stabilized. Difficult access to care and lack of awareness are the main factors causing the emergence of patients in such a late stage. To limit the number of similar cases, patients should follow any swelling that had been growing steadily for several years with overlying skin changes and consult a doctor if persistent systemic symptoms appear.
