A Primary cutaneous leiomyosarcoma located in the left thigh is reported in a 83-year-old patient. The clinical examination found a voluminous ulcero-budding infected tumor, measuring 15 cm long axis. The result of the histological examination and the immuno-histochemical profile revealed the diagnosis of a leiomyosarcoma. The patient underwent extensive excision with cutaneous margins of three to five cm and carried the Gracilis muscle deep down. After one year of control, we did not notice local recurrence. The prognosis remains poor. We recommend long-term follow-up of patients to prevent recurrence. The purpose of this work is to show the difficulties to make the diagnosis and describe our management of this rare case.
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