ABSTRACT

A sarcoma is not so easily recognized due to its wide spectrum of presentation. We describe a rare case of leiomyosarcoma of the perineum which presented as a recurring mass in a young woman, and the plan of management that has been provided. The leiomyosarcoma is one of the rarest varieties of sarcoma. Generally it is observed in the fifth or sixth decade of life. The common site of occurrence is the uterus, and the plan of management is very different compared to other sites. The present case is that of a recurrent perineal mass which was not suspected to be malignant prior to the initial surgery. The patient received chemotherapy once the lesion was diagnosed as rhabdomyosarcoma based on pathology report, immunohistochemistry reports were inconclusive. Recurrance while on chemotherapy lead to change in treatment plan Abdomino-perineal resection was not acceptable to the patient. A treatment plan was decided upon to tailor to the patients needs, a sandwich therapy was decided and pre-operative radiotherapy followed by surgery and adjuvant chemotherapy were given. Patient did not have symptoms of recurrence with a regular three month follow up for one year.