Primary Leiomyosarcoma of the Penis: Review and Update

Leiomyosarcoma of the penis is stated to arise from smooth muscles, which can be from dartos fascia, erector pili in the skin covering the shaft, or from tunica media of the superficial vessels and cavernosa. Prognosis of penile LMS is stated to be difficult to ascertain because reported cases of the tumour are rare. It has been pointed out that leiomyosarcoma of the penis could be classified as superficial tumour or deep tumour based upon the relation of the tumour to the tunica albuginea. It has been pointed out that deep tumours that measure greater 3 cm, high-grade lesions, and tumours that involve the corpora cavernosa, tend to spread locally and metastasize to distant areas and require more radical surgery with or without postoperative radiation therapy. In contrast, it has been stated that superficial lesions could be treated by the undertaking of local excision of the tumour only. It is known that carcinoma of the penis is not common with a worldwide incidence of 0.8 cases per 100,000 men. It is known that the commonest type of cancer of the penis squamous cell carcinoma (SCC) followed by soft tissue sarcoma (STS) and Kaposi sarcoma. Leiomyosarcoma (LMS) of the penis is stated to be the second most common STS subtype afflicting the penis. It has been iterated that about 50 cases of penile LMS had been reported in the English literature by 2022, most of these cases had been reported as isolated case reports while Fetsch and colleagues had reported 14 cases from a single institute. Considering that primary leiomyosarcoma of the penis is not common, it would be envisaged that many clinicians would not have encountered a case before and hence it is important for all clinicians globally to be updated on the manifestations, diagnosis, and treatment of LMS to enable them establish the diagnosis promptly in order to provide adequate and effective treatment for LMS of the penis.