Leiomyosarcoma of the skin and subcutaneous tissue

Abstract

In a study of 65 primary cutaneous leiomyosarcomas and 15 primary superficial subcutaneous leiomyosarcomas, tumors occurred at any age but were more common in middle age and most common on the extremities. They developed as solitary painful or tender intracutaneous or subcutaneous nodules. Microscopically, the cutaneous leiomyosarcomas consist of a poorly delineated proliferation of spindle-shaped atypical myomatous cells arranged in interlacing fascicles which merge into collagenous stroma. Subcutaneous leiomyosarcomas are more sharply circumscribed and typically include a vascular pattern. About 40% of the cutaneous leiomyosarcomas recurred, but none metastasized despite a high mitotic frequency and marked cytologic atypia. Among the 12 patients with subcutaneous leiomyosarcomas, one-half of the tumors recurred and one-third eventuated in metastasis or tumor-related death. Cutaneous leiomyosarcomas have a relatively benign biologic course and may be excised conservatively, but are less likely to recur if the local excision is wide enough to require a skin graft for closure of the surgical defect. For primary subcutaneous leiomyosarcoma, early wide local excision with adequate clear histologic borders constitutes rational treatment.

Clinical course of nonvisceral soft tissue leiomyosarcoma in 225 patients from the Scandinavian Sarcoma Group

“…It is well known that an adequate surgical margin is the most important factor for local control. 9,10,13,29,31,39,40 Our multivariate analysis identified no statistical correlation between local treatment and metastasis or overall survival. This finding is in line with other reports.…”

“…In our series, none of the cutaneous tumors metastasized during follow-up, and none of the patients with cutaneous tumors died from tumorrelated causes, consistent with previous studies, which have shown that strictly cutaneous LMS hardly ever metastasizes. 9,10,18,19,23,26,27,37 At the histopathologic review, we designated 8 tumors (3 in patients who had been referred after recurrence) that extended into both cutis and subcutis as subcutaneous tumors, because their growth pattern denied classification as cutaneous tumors. However, none of these tumors metastasized during follow-up.…”

“…Only a few LMS studies 4,[8][9][10][11][12][13] of any significant size included clinical and follow-up data, and several others [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] analyzed limited numbers of patients with primary LMS at these sites. In addition, many of the previous studies are difficult to interpret, because heterogeneous tumor groups were studied without specifying the localization relative to skin or fascia or the anatomic site.…”

Solitary Dermal Leiomyosarcomas in 12 Ferrets

“…The same criterion is used in humans to differentiate dermal leiomyomas from leiomyosarcomas. 3,4 Dermal leiomyosarcomas in these ferrets were well differentiated, and most neoplastic cells had the cytologic appearance of smooth muscle fibers. Consistent with well-differentiated neoplasms, excision was curative in all 5 animals for which a follow-up was available.…”

Leiomiossarcoma perineal: relato de caso e revisão da literatura

“…Fields e Helwig (8) trataram 59 pacientes com LMS cutâneo usando ressecção conservadora ou ressecção local e encontraram taxa de recorrência de 42%. Entretanto, lesões recorrentes ou residuais que foram totalmente excisadas, geralmente não apresentaram recidiva local nem metástases, ou estavam relacionadas à causa da morte desses pacientes.…”