Primary leiomyosarcoma in the nasal cavity: A case report

Abstract

We experienced a case of leiomyosarcoma occurring from the nasal cavity. The patient was a 60-year-old woman. Her chief complaint at the time of first contact was right chronic nasal obstruction and unexpected nasal bleeding. Upon initial examination, her right nasal cavity was found to be occupied by a solid red-white oval mass with smooth surface. Because of hemorrhagic tumor, incisional biopsy was not performed at pre-treatment. However, endoscopic and image findings suggested that the tumor was malignant. Therefore, an extensive Denker’s operation, with which we could secure an adequate incisional safety margin during operation, was performed. As a result, the final diagnosis was determined to be leiomyosarcoma by immunohistopathological examinations. Because sarcoma cells were not found at the incisional margin microscopically, we considered that we had achieved perfect resection of the tumor. Moreover, full-dose irradiation (70Gy) and seven courses of chemotherapy (vincristine 1.5mg/m 2 , cyclophosphamide 1,200mg/m 2 , actinomycin-D 1.35mg/m 2 ) were performed for adjuvant therapy. Local recurrence and distant metastasis have not appeared at present, which is about five years after treatment. Moreover, both a sufficient cure and acceptable appearance were achieved.