Leiomyosarcoma of the penis

Case report and literature review: Primary leiomyosarcoma of the penis

Background

Leiomyosarcoma (LMS) is a malignant spindle-cell mesenchymal tumor originating from the smooth muscle cells, which mostly affects soft tissues and abdominopelvic organs over extremities. Primary LMS of the penis is a relatively uncommon mesenchymal tissue disease and a poorly understood condition.

Case Report

A 69-year-old man presented with a growing, painless mass protruding from the penis. The irregularly lobulated lump was roughly 3 cm × 2.5 cm, with a smooth surface, tough texture, distinct boundary, and no tenderness. It was determined to be a penile tumor during the preoperative radiological evaluation. The patient underwent resection of the penile mass, followed by extended resection in the second operation. The diagnosis of LMS was verified by pathological examination. During a 20-month follow-up, the patient made a smooth recovery and remained disease-free.

Conclusion

An immunohistochemical examination is essential for rendering this rare diagnosis. Radical excision of tumor lesions with negative cut margins is guaranteed to be the best treatment for primary penile LMS. Close follow-up should be provided due to the high rate of local recurrence.

Primary Leiomyosarcoma of the Glans

Penile leiomyosarcoma isz an extremely uncommon entity that rarely occurs in the glans. Due to the limited number of cases described in literature, guidelines regarding non-surgical treatment, prognosis, and management remain equivocal. Among the mesenchymal tumors of the penis, leiomyosarcoma has the highest propensity for recurrence. It originates in the smooth muscle cells from two distinct locations: superficial and deep. The deep subtype is the most aggressive and has the highest potential for metastasis. Surgical treatment should be implemented early and must be locally aggressive. Herein, we present a rare case of a 54-year-old patient with deep localized leiomyosarcoma of the glans, albeit with superficial characteristics. A review of the main histopathological, clinical, immunohistochemical, and therapeutic aspects of this unusual entity is presented.

Leiomyosarcoma of the Penis: A Case Report and Re-Appraisal

BACKGROUND

Penile leiomyosarcoma arises from smooth muscles, which can be from dartos fascia, erector pili in the skin covering the shaft, or from tunica media of the superficial vessels and cavernosa. We describe presentation, treatment options, and recurrence pattern of this rare malignancy.

CASE PRESENTATION

We present a case of penile leiomyosarcoma in a 70-year-old patient who presented to the urology clinic with 1-year history of a slowly enlarging penile mass associated with phimosis.

CONCLUSIONS

Prognosis of penile LMS is difficult to ascertain because reported cases are rare. Penile leiomyosarcoma can be classified as superficial or deep based on tumor relation to tunica albuginea. Deep tumors (> 3 cm), high-grade lesions, and tumors with involvement of corpora cavernosa, tend to spread locally and metastasize to distant areas and require more radical surgery with or without postoperative radiation therapy. In contrast, superficial lesions can be treated with local excision only.

Primary leiomyosarcoma of the skin: a comprehensive review on diagnosis and treatment

Sarcomas are a heterogeneous group of mesenchymal tumors which can affect bone and soft tissue. Leiomyosarcoma (LMS) is a rare subtype localized to the skin or subcutaneous tissue. Due to the heterogeneity of sarcomas, reviews and guidelines with an in-depth focus specifically on primary LMS of the skin are sparse. This article is intended to provide an up to date and systematic overview on diagnosis, treatment, and surveillance of this rare entity to provide a framework for decision making and management for dermato-oncologists. We discuss novel treatment options for advanced disease such as targeted therapy with kinase inhibitors and immune checkpoint blockade which may improve the prognosis even in advanced stages of LMS.

[Leiomyosarcoma of the foreskin : A rare case of mesenchymal foreskin tumor]

We report a case of a rare mesenchymal foreskin tumor. A slow-growing node was detected during the urological examination of a 39-year-old man. A histological examination following the node excision showed a superficial leiomyosarcoma. Superficial leiomyosarcomas rarely metastasize and are associated with a better prognosis than deeper tumors. The patient had no relapse 9 months after a successful radical circumcision. We strongly recommend a histological examination whenever a growing node in the genital area is found.

Superficial leiomyosarcoma of the glans: report of a case and literature review

Primary leiomyosarcomas of the penis are rare. Clinically and pathologically, these tumors fall into two groups: superficial and deep. Superficial lesions usually are low grade and show a limited tendency toward distant metastasis. In contrast, deep-seated tumors usually show a more aggressive behavior associated with a poor prognosis. A 62-year-old man with a superficial leiomyosarcoma of the glans penis is reported.

Primary Penile Leiomyosarcoma: Case Report and Review of the Literature

Primary leiomyosarcoma of the penis is very rare. Since 1930, only 53 cases have been re-ported in the international literature.

We describe a case of primary leiomyosarcoma of the penis diagnosed in 2008 in a 63-year-oldman, presented to our department with a firm-fibrous mass involving the ventrolateral side of the shaft, treated with local excision and 3 times locally recurred.

We also attempt a review of the literature regarding evolution, progression, differential diagnosis and possible treatment of this disease.

Leiomyosarcoma of the penis

We report a case of a 78-year-old patient with penile leiomyosarcoma, treated by radical penectomy. Two years after the operation the patient is without evidence of local recurrence or metastatic disease.We also discuss the treatment options and attempt a review of the literature.

Deep-seated sarcomas of the penis

Mesenchymal neoplasias represent 5% of tumors affecting the penis. Due to the rarity of such tumors, there is no agreement concerning the best method for staging and managing these patients. Sarcomas of the penis can be classified as deep-seated if they derive from the structures forming the spongy body and the cavernous bodies. Superficial lesions are usually low-grade and show a small tendency towards distant metastasis. In contrast, deep-seated lesions usually show behavior that is more aggressive and have poorer prognosis. The authors report 3 cases of deep-seated primary sarcomas of the penis and review the literature on this rare and aggressive neoplasia.

A rare case of leiomyosarcoma of the penis with a reappraisal of the literature

Primary leiomyosarcomas arising in the penis are rare, with only 29 reported cases to date. We review the published records on this entity and describe an additional case of penile leiomyosarcoma occurring in a 53-year-old patient who underwent postectomy for a firm nodule in the prepuce. Four years later he experienced local recurrence which was successfully treated with partial penectomy.

Leiomyosarcoma of the Penis

Primary leiomyosarcomas of the penis are very rare. To date, less than 30 have been documented in the English language literature. In this report, we describe the clinical, histopathologic, and immunohistochemical findings in 14 cases retrieved from our files. The patients ranged in age from 43 to 62 years (mean age, 51 years) at the time of initial surgical resection. The tumors involved the prepuce (n = 1), prepuce and distal shaft (n = 1), circumcision scar line (n = 2), circumcision scar line and distal shaft (n = 1), shaft (n = 5), base of the penis (n = 3), and penis, not otherwise specified (n = 1). The lesions ranged in size from 0.5 to 6.0 cm (median size, 1.5 cm) in greatest dimension. Nine tumors were superficially located, two were of indeterminate depth, and three were deep-seated. The superficial tumors were relatively asymptomatic, and seven were reportedly present for 1 year to more than 20 years (median duration, 5 years) before medical attention was sought. In contrast, one deep-seated lesion caused dysuria and difficulty voiding, prompting the patient to seek a clinical opinion within only a few months of the apparent onset. Histologically, all tumors contained smooth muscle cells with both cytologic atypia and mitotic activity. Immunohistochemical studies were available for nine tumors, and immunoreactivity for desmin was present in all instances. All patients were initially treated with a local procedure. Follow-up information is available for 9 of the 14 patients (64%), with a median follow-up interval of 12 years 11 months. Three patients had multiple (two to four) local recurrences. Two of these patients were ultimately treated with a wide local excision or partial penectomy, and both were alive and well at last follow-up. In contrast, one patient, who had four local recurrences and refused a penectomy, developed a distant metastasis 10 months after the fourth recurrence. The best predictors of outcome are tumor depth and tumor size. Superficial leiomyosarcomas of the penis are optimally managed by wide local excision whenever this is technically feasible. Tumors with a deep-seated component may require more aggressive intervention to ensure complete removal.

Dermal leiomyosarcoma

Leiomyosarcoma of the skin is a rare tumor that cannot be diagnosed clinically because its gross appearance is nonspecific. The primary skin tumor usually appears as a solitary nodule. It may arise de novo in the dermis or in the subcutaneous tissue, or as a metastatic lesion from an internal neoplasm. Dermal leiomyosarcomas rarely metastasize, unlike the subcutaneous tumors. We describe a case of the dermal type of leiomyosarcoma.