SCIATICA AS THE FIRST MANIFESTATION OF A LEIOMYOSARCOMA OF THE BUTTOCK

We report the case of a 22-year-old woman who was admitted for inflamm atory right-sided sciatica with a decline in general health, Laborator y tests showed severe inflammation, Ultrasonography and computed tomog raphy of the buttock and pelvis demonstrated a large tumor in the deep muscles of the right buttock, with an intrapelvic component that disp laced the pelvic organs without invading them, Histologic examination of a biopsy specimen taken via the buttock established the diagnosis o f leiomyosarcoma, Surgery by a pelvic approach allowed partial resecti on of the tumor, which was seen to invade the sciatic nerve, Radiation therapy was given, Six months later the residual tumor was considerab ly larger and the patient's general health had deteriorated further, L eiomyosarcomas are rare tumors whose diagnosis rests on histologic exa mination of biopsy or surgical specimens, The treatment is surgical, R ecurrences are seen in 40 to 60% of cases, and metastases in 27 to 60% , The place of radiation therapy and chemotherapy in the treatment of leiomyosarcoma remains unclear.