Primary Leomyosarcoma Of The Femur and Bony Metastases From
The Breast In The Same Patient
S Vaidya
Sandwell Healthcare NHS Trust, Lyndon,
West Bronwich, West Midlands, UK
Corresponding address: Dr. S Vaidya, 15 Overton
Place, West Bromwich, West Midlands B71 1RL, UK
Abstract
A 78-year-old lady, with no history of trauma,
was admitted with gradually increasing pain in the right groin
and thigh; she had been unable to weight-bear for 24 h. The patient
also complained of intermittent left shin pain. She had been treated
for carcinoma of the breast 22 years earlier by total mastectomy
with axillary clearance followed by local radiotherapy; she showed
no signs of recurrence. The plain X-ray revealed a pathological
fracture of the right proximal femur with a large osteolytic lesion.
The left tibial radiograph showed extensive osteolytic lesions.
The patient underwent palliative internal fixation of both the
femur and the tibia. The histopathological report from the right
femoral biopsy revealed a primary leiomyosarcoma and from the
left tibia revealed a bony metastasis from a breast primary. Further
investigation excluded any extraskeletal leimyosarcoma. Primary
leimyosarcoma is a very rare tumour involving long bones in adults;
only a few cases have been reported in world literature. The breast
tumour gave rise to a bony metastasis 22 years after 'cure' and
without local recurrence, which is again very uncommon. Such a
combination is previously unreported.
Key words
Primary leimyosarcoma, femur, bony, metastasis,
breast carcinoma, tibia, orthopaedics
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