Postauricular Leiomyosarcoma: A Case Report and Literature Review

Leiomyosarcoma arising in the head and neck region is a rare entity. Auricular involvement by the disease is further rarer with few cases reported in the literature. Usually auricular leiomyosarcoma is a disease of middle-old age. We report a case of leiomyosarcoma of the postauricular region in a young adolescent female. Surgery along with adjuvant radiotherapy was used for complete cure. Patient is disease-free for the last eight years and is on regular yearly followup. The aim of reporting this case is to add to the scarce existing literature regarding auricular leiomyosarcoma and its long-term outcome. Also, this is the first case report in young adolescent and second only of the post auricular region. 1. Introduction Leiomyosarcoma constitutes a rare group of malignant tumor of the mesenchymal origin constituting 6% of all soft tissue sarcoma. About 3% to 10% of all leiomyosarcoma are found in head and neck region [1]. Leiomyosarcoma of the ear is further rarer site in the category of head and neck region. The origin of tumor is proposed to be from smooth muscle present in walls of blood vessels and the erector pili musculature of skin [1, 2]. We report a case of leiomyosarcoma arising in the postauricular region in a 15-year-old adolescent female with long-term followup. We reviewed the Pubmed database for the term “leiomyosarcoma of ear/temporal bone” and found only 10 cases reported from 1964 to 2011. All case reports were summarized for age, sex, site of origin, treatment modality used, and follow-up period (Table 1). To the best of our knowledge, this is the first case report in the literature of postauricular leiomyosarcoma in a young adolescent with long-term followup. Table 1: Summary of previously reported cases of leiomyosarcoma involving ear/temporal bone. 2. Case Report A 15-year-old female presented with 8-month history of progressive painless nodular swelling in right postauricular region. There was no history of ear discharge, ear pain, ear bleeding, or impairment of hearing. Patient had undergone local excision of swelling twice at local hospital within 1-month interval. Patient again had recurrence of swelling and for which she was referred to our centre. On examination, a 3/4？cm nontender firm nodular swelling with overlying scar mark (previous surgeries) was present in the right postauricular region. There was no palpable lymphadenopathy, and rest of the otolaryngological examination was within normal limit. Tympanic membrane and external auditory meatus was normal. Fine needle aspiration cytology (FNAC) was suggestive for