Rare case of giant ischiorectal leiomyosarcoma

Introduction: Leiomyosarcoma is a rare type of soft tissue sarcoma especially giant ones (size >5 cm). It is usually arises from the uterus and retroperitoneum. Ischiorectal space is not a common site for primary leomyosarcoma. There are only few case reports about Ischiorectal leiomyosarcoma.<br /> Presentation of case: We present a case of 25 yrs. old female patient, who presented with a swelling on left buttock. It measures 9 by 9.5 by 18 cm on MRI. Complete tumor excision done and immunohistochemistry tests confirmed the diagnosis of leiomyosarcoma. Discussion: Due to its rarity, unusual site and large size leiomyosarcoma poses a great challenge for a surgeon both to diagnose and manage it. Early diagnosis and management improves prognosis and decreases recurrence rate because sarcomas have high recurrence rate. It is highly recommended to have multidisciplinary approach.<br /> Conclusion: The case report highlights on both diagnostic and therapeutic challenges associated with giant leiomyosarcoma. There are no strict guidelines to follow when managing this type of cases but rather approach has to be individualized. Since there are only few case reports on this specific pathology we advocate for surgeons to share their experience on similar cases.