Çetindağ MF et al. American Journal of Cancer Case Reports 2014, 2:112-122 Ivy Union Publishing | http: //www.ivyunion.org October 17, 2014 | Volume 2 | Issue 2 Page 1 of 11 A Primary Leiomyosarcoma of the Thyroid Gland: A Case and Literature Review Mehmet Faik Çetindağ 1* , Ibrahim Gullu 2 , Osman Abbasoglu 3 , Ipek Pınar Aral 1 , Fatih Goksel 4 , Yasemin Cihan 5 , Atiye Yılmaz Ozsavran 1 , Olcay Kandemir 6 , and Dincer Yegen 1 1 Department of Radiation Oncology Turkish Ministry of Health Ankara Atatürk Training and Research Hospital, Turkey 2 Department of Medical Oncology, Hacettepe University Faculty of Medicine, Turkey 3 Department of General Surgery, Hacettepe University Faculty of Medicine, Turkey 4 Turkish Ministry of Health Dr.A.Y.Ankara Onkoloji Training and Research Hospital, Turkey 5 Department of Radiation Oncology, Turkish Ministry of Health Kayseri Training and Research Hospital, Turkey 6 Department of Pathology, Turkish Ministry of Health Dr.A.Y. Ankara Onkoloji Training and Research Hospital, Turkey Keywords: thyroid, leiomyosarcoma; radiotherapy; chemotherapy Academic Editor: Xiaoning Peng, Hunan Normal University School of Medicine, China Received: May 14, 2014; Accepted: September 6, 2014; Published: October 17, 2014 Competing Interests: The authors have declared that no competing interests exist. Copyright: 2014 Çetindağ MF et al . This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. *Correspondence to: Mehmet Faik Çetindağ, Department of Radiation Oncology Turkish Ministry of Health Ankara Atatürk Training and Research Hospital, Turkey; Email: faikcetindag@gmail.com Abstract Introduction: We want to present a rare case of Primary leiomyosarcoma of the thyroid (PLT) gland and review the literature on PLT including the differential diagnoses, pathology, and alternative treatment strategies. Presentation of Case: A 56-year-old man who underwent left side total thyroidectomy with diagnosis of substernal goiter. On pathologic examination, three different pathology clinics had a common opinion that this was a grade 3 pleomorphic sarcoma of thyroid itself. Positron Emission Tomography (PET/CT) obtained one month after surgery displayed no distant metastases. Loco regional radiotherapy (RT) to the thyroid bed was delivered up to a dose of 59.4 Gray (Gy) in 1.8 Gy daily fractions. PET/CT obtained three months after RT showed bilateral multiple lung metastases without loco regional recurrence. The patient received 6 courses of doxorubicin and cyclophosphamide based chemotherapy. A new PET/CT scan showed only two metabolically active metastases on both lungs. Because of disappearance of small metastases, the patient underwent sequential bilateral metastasectomy in one month interval. Pathology results verified the metastases of PLT. The patient is still alive without any signs of disease 6 years after RT and he is the only long surviving case reported up to now. Conclusion: The treatment protocols for PLT have not been well established yet, because of their rareness and poor prognosis. We believe that our case may be directive for PLT treatment. American Journal of Cancer Case Reports Case Report American Journal of Cancer Case Reports http://www.ivyunion.org/index.php/ajccr Vol. 2, Article ID 201400403, 11 pages