 | AP radiograph reveals a soft tissue mass in the distal leg. A defect is seen (arrow) indicating extension into the fibula, and the presence of an aggressive neoplasm. |
 | Lateral radiograph demonstrates the same soft tissue mass, also showing extension into the fibula. |
 | MRI demonstrates the tumor mass to be heterogenous and fairly well marginated. |
 | The histosections demonstrate core needle biopsies (low and high power) to be a moderately cellular neoplasm with a collagen background and tumor necrosis. The cells are pleomorphic with blunt tipped nuclei. "Cigar" chaped nuclei with pleomorphism histologically suggests the diagnosis of leiomyosarcoma. |
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| Treatment was chemotherapy and wide resection via BK amputation. Gross examination revealed a 10x10x20 cm tumor mass replacing the muscles in the posterior compartment of the leg, and grossly invading the fibula. The patient developed pulmonary metastases three years later, and died soon afterwards. |
 | This immunoperoxidase stain indicates the tumor is rich
in smooth muscle actin and supports the diagnosis of leiomyosarcoma.
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