Advanced Magnetic Resonance Imaging in the Evaluation of a Chronic Non-healing ulcer - A Case Report of Rare Primary Cutaneous Leiomyosarcoma.

Background: Primary cutaneous leiomyosarcoma of the skin is extremely uncommon superficial soft tissue sarcoma. The uniqueness of this case is the exceedingly rarity of the tumor and its potential to be clinically misdiagnosed as squamous cell carcinoma. We report an interesting and rare case of PCL with unusual clinical presentation.

Methods: Our case documents the radiological approach and importance of newer magnetic resonance imaging sequences in helping the diagnosis of a rare case of primary en plaque cutaneous leiomyosarcoma of lower extremity in a 60-year-old male, farmer by occupation with superficial ulceration and local invasion presenting as chronic non-healing ulcerative lesion.

Conclusions: Contrast-enhanced MRI when coupled with advanced imaging sequence such as magnetic resonance spectroscopy and diffusion-weighted imaging further increases malignant probability of the lesion and guides the surgeon for a definite treatment plan.