Leiomyosarcoma of the Skin

Bernstein, Steven; Roenigk, Randall K.

doi:10.1111/j.1524-4725.1996.tb00609.x

Cited by 73 publications

(43 citation statements)

References 20 publications

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“…Surgical excision of dermal LMS has a recurrence rate of 14–32% [4, 14]. Metastasis, however, is rare [4, 14, 15]. Micrographic surgery has been reported on five occasions in dermal LMS, with no recurrence reported to date [4, 16, 17, 18].…”

Section: Discussionmentioning

confidence: 99%

“…Metastasis, however, is rare [4, 14, 15]. Micrographic surgery has been reported on five occasions in dermal LMS, with no recurrence reported to date [4, 16, 17, 18]. Subcutaneous LMS is more aggressive with a local recurrence rate of 46–47% after wide surgical excision [4, 14]and metastasis in 32–62% of cases [4, 14, 15].…”

Section: Discussionmentioning

confidence: 99%

“…In these tumours micrographic surgery has the lowest local recurrence rates (table 2) [1, 2, 3, 4, 5]. The occurrence of tumour metastasis depends on other factors.…”

Section: Discussionmentioning

confidence: 99%

“…Cutaneous LMS occurs most often on the extremities (dorsal thigh) and the trunk, including the genitalia. Surgical excision of dermal LMS has a recurrence rate of 14–32% [4, 14]. Metastasis, however, is rare [4, 14, 15].…”

Section: Discussionmentioning

confidence: 99%

“…Cutaneous leiomyosarcoma (LMS) is classified as dermal and subcutaneous [4, 14]. Dermal LMS are derived from the arrector pili muscle of the hair follicle.…”

Section: Discussionmentioning

confidence: 99%

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Micrographic Surgery (‘Slow Mohs’) in Cutaneous Sarcomas

et al. 1999

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Background: Micrographic surgery (MS) results in very low local recurrence rates in all sorts of skin tumours that grow by extensive subclinical infiltration. Therefore, MS should prove useful in the treatment of cutaneous sarcomas. Objective: To treat cutaneous sarcoma with MS in order to minimize local recurrence rates. Methods: We treated 5 cases of dermatofibrosarcoma protuberans and 5 cases of cutaneous sarcomas of different origin (atypical fibroxanthoma, malignant fibrous histiocytoma, malignant peripheral nerve tumour) with micrographic surgery using paraffin-embedded sections. In primary cutaneous sarcomas, tumour extensions were readily detected in HE sections. In recurrent tumours, special stains were needed to distinguish tumour extensions from scar tissue. Results: All patients were treated successfully and have remained free of local recurrences as of yet. Solitary pulmonary metastasis occurred in 1 patient with high-grade malignant peripheral nerve tumour. Conclusion: MS is an excellent procedure to minimize local recurrence in cutaneous sarcomas. Cutaneous sarcomas with low metastatic potential can be cured with MS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In these tumours micrographic surgery has the lowest local recurrence rates (table 2) [1, 2, 3, 4, 5]. The occurrence of tumour metastasis depends on other factors.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Cutaneous leiomyosarcoma (LMS) is classified as dermal and subcutaneous [4, 14]. Dermal LMS are derived from the arrector pili muscle of the hair follicle.…”

Section: Discussionmentioning

confidence: 99%

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Micrographic Surgery (‘Slow Mohs’) in Cutaneous Sarcomas

et al. 1999

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

Svarvar¹,

Böhling²,

Berlin³

et al. 2007

Cancer

127

133

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BACKGROUND.Leiomyosarcoma of nonvisceral soft tissues is an uncommon malignant tumor; thus, only small numbers of cases have been reported. This study was based on a large series of patients from the Scandinavian Sarcoma Group Register acquired during a 15‐year period (from 1986 to 2001). Follow‐up information was available for all patients.METHODS.The authors analyzed the clinical features of 225 patients with cutaneous, subcutaneous, or deep‐seated leiomyosarcoma of the extremities, trunk wall, and superficial parts of the head and neck region to determine the natural course of the disease. Only patients who received their treatment at a specialist sarcoma center were included. Re‐evaluation of histopathology was performed.RESULTS.The age of the patients (121 women and 104 men) ranged from 20 years to 98 years (median, 70 years), and the tumors ranged in size from 0.6 cm to 35 cm (median, 4.0 cm). Eighty‐two percent of the tumors were classified as high grade. The median follow‐up for survivors was 5.5 years. The local treatment was adequate in 154 of 206 patients (75%) who were without metastasis at presentation. At 10 years, 84% of the 206 patients with localized disease at presentation were free from local recurrence, 66% remained metastasis free, and 49% were alive. Multivariate analysis showed that higher malignancy grade (P = .006), larger tumor size (P = .003), and deeper tumor location (P = .002) were correlated significantly with decreased metastasis‐free survival, inadequate local treatment was correlated with local recurrence (P = .007), and high malignancy grade was correlated with decreased overall survival (P = .007).CONCLUSIONS.The long‐term prognosis for patients with subcutaneous and deep‐seated soft tissue leiomyosarcoma remains poor despite the ability to achieve adequate local control through nonmutilating surgery with or without radiotherapy. Cancer 2007. © 2006 American Cancer Society.

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Cutaneous soft tissue sarcoma incidence patterns in the U.S.

Rouhani

Fletcher

Devesa

et al. 2008

Cancer

307

228

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BACKGROUND.Cutaneous soft tissue sarcomas (CSTS) are a heterogeneous group of mesenchymal neoplasms. To the authors' knowledge, no prior large, population‐based study has focused on CSTS.METHODS.Surveillance, Epidemiology, and End Results (SEER) Program incidence and relative survival rates of CSTS were analyzed according to race, sex, and histologic type using the 2002 criteria of the World Health Organization classification.RESULTS.Among residents of the 13 SEER registries, 12,114 CSTS were diagnosed from 1992 through 2004. Overall age‐adjusted CSTS incidence rates were highest among blacks (30.8 per 1,000,000 person‐years) followed by whites (25 per 1,000,000 person‐years), and American Indians/Alaska Natives (11.2 per 1,000,000 person‐years) and were lowest among Asian/Pacific Islanders (7.7 per 1,000,000 person‐years). Kaposi sarcoma (KS) accounted for 71.1% of cases, and the rates were similarly ranked. Dermatofibrosarcoma protuberans (DFSP) rates also were highest among blacks, whereas leiomyosarcoma (LS) and angiosarcoma (AS) rates were highest among whites. The rate ratio of men to women was 25.5 for KS, 4.7 for malignant fibrous histiocytoma (MFH), 3.7 for LS, 2.0 for AS, and 0.9 for DFSP. The 5‐year relative survival rates were 99% for patients with DFSP, 89% for patients with MFH, 92% for patients with LS, and 45% for patients with AS. KS rates among men in the original 9 SEER registries increased more than 30‐fold during the 1980s before they peaked around 1991 and subsequently declined rapidly because of human immunodeficiency virus‐associated KS and highly active antiretroviral therapy. This KS pattern was evident not only among those ages 20 to 59 years but also among those ages 60 to 69 years. From 1978 through 2004, LS and AS rates among whites increased exponentially.CONCLUSIONS.CSTS rates varied markedly over time and by race, sex, and histologic type, supporting the notion that these histologic variants of CSTS areetiologically distinct. Cancer 2008. © 2008 American Cancer Society.

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Leiomyosarcoma of the Skin

Abstract: The vast majority of tumors were treated by excisional surgery with wide margins, but conceptually, Mohs' micrographic surgery should prove useful for the treatment of this tumor as it has with other skin cancers displaying contiguous growth.

Cited by 73 publications

References 20 publications

Micrographic Surgery (‘Slow Mohs’) in Cutaneous Sarcomas

Micrographic Surgery (‘Slow Mohs’) in Cutaneous Sarcomas

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

Cutaneous soft tissue sarcoma incidence patterns in the U.S.

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