Recurrent nodule on the nasal columella: a good reason to re‐biopsy

Abstract

Leiomyosarcoma is a difficult diagnosis to make clinically and requires histological confirmation. Re-biopsy of a "benign" growth may be necessary if clinicopathological correlation does not match with the clinical behavior of the tumor in question. Finally, Mohs micrographic surgery is a useful treatment modality for leiomyosarcomas, particularly those located in cosmetically-sensitive regions of the body such as the nose.

Spindle Cell Neoplasms Encountered in Dermatologic Surgery: A Review

“…Unfortunately, local recurrence rates range from 30% to 45% after WLE. To the best of our knowledge, there have been 27 cases of superficial LMS excised with MMS reported in the literature, with two recurrences overall (7.4%) . Starling and Coldiron described the largest series, reporting 11 patients treated with MMS with no recurrences at an average follow‐up of longer than 4 years …”

“…12,146,[153][154][155][156][157] Starling and Coldiron described the largest series, reporting 11 patients treated with MMS with no recurrences at an average follow-up of longer than 4 years. 157 Although the rarity of superficial LMS limits our ability to draw firm conclusions with regard to the most-efficacious treatment modality, current literature supports MMS as first-line therapy because of its tissue-sparing advantage and rate of recurrence equal or better than that of WLE (Table 2). MMS may be particularly advantageous in treating the cutaneous subtype of LMS, which arises more commonly on the head and neck and is more superficial in depth.…”

Crusted pink papule in a 20‐year‐old

“…The S-100 stain was negative in this case, which excludes spindle cell melanoma. 5 Our patient was referred to Mohs surgery. 4).…”

“…[2][3][4][5][6][7][8] Most patients with leiomyosarcoma are middle-aged individuals, often presenting with solitary tender nodules on the head and neck. 1 Superficial leiomyosarcomas are classified as cutaneous or subcutaneous based on their histologic location.…”

Fibro-hyaline extensions from the bony nasal aperture, causing nasal obstruction

“…[3][4][5][6][7][8] Solitary fibrous neoplasm has been reported only in the nasal cavity. 1 These neoplasms are usually solitary and non-symmetrical.…”