Primary orbital leiomyosarcoma

Abstract

Leiomyosarcoma is a malignant soft tissue tumor of mesenchymal origin, which is uncommonly located on the head-neck regions.  There are just a few cases reported in the literature of orbital leiomyosarcoma. Given the poor prognosis of this neoplasia a prompt suspicion, diagnosis and early treatment can influence the course and survival of these patients. We present the first case of orbital leiomyosarcoma in Colombia; an elderly patient who consulted due to an 8-month history of progressive increase in size in the left fronto-temporal region accompanied by dysarthria, vision loss, and ipsilateral painful proptosis. Imaging studies showed an extensive osteolytic injury with orbital and Central Nervous System involvement. An incisional biopsy was performed, which reported a high-grade leiomyosarcoma. After ruling out metastases, a complete excision of the lesion and radiotherapy were given. Ensuring a 10-month follow-up, the patient had a favorable evolution without local recurrences or distant metastases.