Primary Penile Leiomyosarcoma of Penis: A Rare Case Report

Penile tumors rarely include mesenchymal tumors, and within this group, sarcomas are even more uncommon. We report a case of primary leiomyosarcoma of the penis in a 45-year-old male who underwent total penectomy for an ulcero-proliferative mass involving the distal shaft and extending up to the base of the penis. Grossly, the tumor measured $10\times5\times5$ cm. Microscopic examination revealed spindle cells arranged in fascicles with cigar-shaped nuclei and marked atypia. Immunohistochemistry showed positivity for vimentin, smooth muscle actin, and h-caldesmon, confirming smooth muscle origin. The histopathological examination and immunohistochemical workup remain the gold standard for rendering this diagnosis at such a rare site. This case emphasizes the importance of accurate diagnosis and complete surgical excision, along with long-term follow-up for optimal patient outcomes.