Bolat Shalabaev1, Svetlana Kurash2, Aibar Nurzhanov1, Dulat Serikbaiuly1, Bayram Kochiev3, Almira Manatova4, Zhandos Burkitbayev5 and Zhuldyz Kuanysh4 1 Multidisciplinary Surgery Center, National Research Oncology Center, Astana, Kazakhstan 2 Pathomorphology Center with Cytology, National Research Oncology Center, Astana, Kazakhstan 3 Radiation Diagnostic Center, National Research Oncology Center, Astana, Kazakhstan 4 Department of Science, National Research Oncology Center, Astana, Kazakhstan 5 Chairman of the Board, National Research Oncology Center, Astana, Kazakhstan Correspondence to: Zhuldyz Kuanysh, email:zhuldyzkuanysh@icloud.com Keywords: laryngeal leiomyosarcoma; immunohistochemistry; supraglottic mass; laryngectomy; leiomyosarcoma Received: May 28, 2025 Accepted: March 19, 2026 Published: May 04, 2026 Copyright: © 2026 Shalabaev et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ABSTRACT Background: Laryngeal leiomyosarcoma (LLMS) is an exceptionally rare malignant tumor, accounting for less than 1 % of all laryngeal cancers, which are predominantly epithelial in origin. Since the first description in 1939, fewer than 70 cases have been reported worldwide. In the largest pooled analysis reported a 5-year overall survival rate of 64%, with distant metastasis identified as the main adverse prognostic factor. Case presentation: We report a 64-year-old male who presented with progressive dyspnea and hoarseness caused by a supraglottic mass. Preoperative biopsy revealed spindle-cell proliferation consistent with leiomyosarcoma (SMA +, Vimentin +, Ki-67 60 %). Comprehensive staging with CT, MRI, and ultrasound excluded regional and distant metastases. The patient underwent extended laryngectomy with R0 margins and left neck dissection (levels II–IV). Based on multidisciplinary tumor-board discussion, four cycles of adjuvant doxorubicin and ifosfamide were administered according to national sarcoma guidelines. At 12-month follow-up, the patient remains alive and free of disease. Conclusions: This report, representing the first documented case of LLMS from Central Asia, contributes to the limited global experience with this rare tumor. Our review identified four additional LLMS cases published between 2021 and 2024, totaling five recent reports including the present case. Collectively, these demonstrate persistent male predominance, glottic and supraglottic predilection, and survival outcomes consistent with previous observations. Complete surgical excision remains the cornerstone of therapy, while multidisciplinary-guided adjuvant treatment may benefit selected high-grade or high-risk patients. Continued accumulation and molecular characterization of cases are needed to refine prognostic assessment and optimize management strategies.
Shalabaev et al. (Mon,) studied this question.