Leiomyosarcoma (LMS) of the vulva is rare. However it is the most common histologic subtype of vulvar sarcoma, accounting for approximately 1% of all vulvar malignancies. [1-8] Whether genetics and epigenetics play a role in pathogenesis is unclear. [1] The tumor is slow-growing with non-specific symptoms, has high metastatic potential, and follows a bimodal age distribution. [1-8] Diagnosis and prognosis are based upon immunohistochemical expression and criteria from early literature. [1,3,5-7] The most common therapeutic approach involves radical vulvectomy with lymph node resection. The value of adjuvant chemotherapy and radiation remains unknown. [1,3,5-8] Our case describes a 46-year-old Caucasian G2P2 female with LMS of the left labia
