Subcutaneous Leiomyosarcoma of the Anterior Abdominal Wall: A Case Report

Abstract

Background: Leiomyosarcoma is a rare malignant mesenchymal tumour arising from smooth muscle cells and accounts for approximately 5–10% of all soft tissue sarcomas. Subcutaneous leiomyosarcomas are particularly uncommon, representing only 1–2% of all superficial soft tissue malignancies. They occur most frequently on the extensor surfaces of the extremities, while involvement of the anterior abdominal wall remains exceptionally rare. Case Presentation: We report a rare case of subcutaneous leiomyosarcoma arising from the left rectus abdominis muscle of the anterior abdominal wall. The patient presented with a progressively enlarging abdominal wall mass. Radiological investigations demonstrated a localised soft tissue tumour without evidence of distant spread. The diagnosis was established through histopathological examination and confirmed by immunohistochemical analysis. The patient underwent wide surgical excision of the lesion, including the involved rectus abdominis muscle and adjacent peritoneum, with the objective of achieving tumour-free margins. Histopathological evaluation confirmed the diagnosis of subcutaneous leiomyosarcoma. The postoperative course was uneventful, and the patient was enrolled in regular follow-up. Conclusion: This case highlights the exceptional rarity of subcutaneous leiomyosarcoma of the anterior abdominal wall and emphasises the importance of histopathological and immunohistochemical assessment for accurate diagnosis. Complete surgical resection with adequate margins remains the cornerstone of treatment and offers the best chance for long-term local control.