Primary lymphatic leiomyosarcoma presenting as a pelvic mass

This is a unique case of widely metastatic, yet lymphatic confined LMS in a patient with very remote history of TAH/BSO. The tumor responded well to surgical resection and aromatase inhibition. Although traditionally LMS does not involve lymphatic spread, this case demonstrates that LMS should remain in the differential when bulky lymphadenopathy is encountered. While there are rare cases of primary retroperitoneal LMS, this may be the first reported case of primary lymphatic LMS.