title: Recurrent nodule on the nasal columella: a good reason to re-biopsy.
abstract: BACKGROUND
  A 15-year-old Caucasian male presented with 9-month history of a recurrent nodule on the nasal columella. The previous biopsy was reported as a neurofibroma.
  
  
  METHODS
  Frozen sections revealed a spindle cell neoplasm. Permanent section immunohistochemistry sections stained positive for vimentin and smooth muscle actin and negative for S100 and CD34, confirming the diagnosis of leiomyosarcoma.
  
  
  RESULTS
  The tumor was removed using Mohs micrographic surgery. Radiological work-up revealed no distant metastasis. There has been no local recurrence to date.
  
  
  CONCLUSIONS
  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.
authors.affiliation: DermSurgery Associates, Houston, and ProPath Laboratories, Dallas, Texas 77030, USA.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Vujevich
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Goldberg
authors.forename: Arash
authors.initials: A
authors.lastname: Kimyai-Asadi
authors.forename: Robert
authors.initials: R
authors.lastname: Law
mesh_terms: D000293:Adolescent; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D007150:Immunohistochemistry; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008297:Male; D015580:Mohs Surgery / Q000379:methods; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D009455:Neurofibroma / Q000175:diagnosis / Q000473:pathology*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology*; D016896:Treatment Outcome