Pre-surgical management of primary leiomyosarcoma of the bone

Leiomyosarcoma is a rare type of smooth muscle cell tumor, with an incidence of 7-10% compared to other types of sarcomas. It develops primarily in the retroperitoneal cavity, the genital tract and extremities. Leiomyosarcoma can also affect the bone, either as a primary tumor or as metastasis. Primary osseus leiomyosarcoma is a rare finding in patients with radiologically identified osteolytic lesions having an incidence of <1% of total primary bone tumors.Due to its low incidence patients with primary osseous leiomyosarcoma are never diagnosed before immunohistochemical analysis and case management is difficult because of the lack of specific indications pertaining to primary osseus leiomyosarcoma. Data on age specific incidence is scarce but there seems to be a tendency towards a higher incidence with advanced age. The purpose of this work is to discuss the complete management of primary osseus leiomyosarcomas based on interdisciplinary medical teams’ indications in a Romanian hospital setting.