Somatic Soft Tissue Leiomyoma in an Elderly Patient: A Case Report and Review of Existing Literature

Abstract

Leiomyomas of deep soft tissue have been traditionally divided into gynecologic and somatic leiomyomas. Somatic
leiomyoma is exceedingly rare and usually has excellent outcome. We report a case of slow growing lower extremity
somatic leiomyoma in a 63-year-old man. It has been predominantly reported to affect younger age
group. Our patient is the oldest reported patient in the English language literature. Macroscopically, the specimen
consisted of a nodular lesion with focal calcification, measuring 3.1 x 2.2 x 1.5 cm. Microscopically, this was a wellcircumscribed,
mature smooth muscle tumour with a fibrous pseudocapsule and dense calcification admixed with
areas of hydropic and myxoid change, and mild parenchymal and perivascular hyalinization. The smooth muscle
cells exhibited focal minimal atypia without increased mitotic activity or necrosis. All margins were clear of tumour.
Immunohistochemically, the neoplastic cells were strongly and diffusely positive for smooth muscle markers.
The case was reported as “somatic type smooth muscle tumour of soft tissue, probably benign”, and close
clinical and radiological follow-up was recommended. The patient remains clinically recurrence-free four months
after the diagnosis.