title: Primary cutaneous leiomyosarcoma: clinicopathological analysis of 36 cases.
abstract: OBJECTIVE
  Cutaneous leiomyosarcomas (LMS) are rare in comparison with their deep-seated soft tissue and uterine counterparts, and have been poorly characterized. The aim was to verify whether the clinical behaviour of purely dermal LMS is different from that of LMS with minimal subcutis invasion.
  
  
  RESULTS
  Twenty-one purely dermal LMS and 15 dermal LMS with minimal subcutis extension were analysed. Tumours developed in 27 men and nine women (age range 29-91 years); most tumours showed a fasciculated (n = 23), pilar-type (n = 12) and pleomorphic (n = 1) pattern. During the follow-up period (range 2-192, mean 41 months) recurrences occurred in 1/16 (6.2%) of tumours confined to the dermis and in 2/11 (18.1%) tumours with minimal subcutis extension. The three recurrent tumours were high-grade LMS, two of which exhibited myxoid areas. One patient with a pleomorphic dermal LMS with minimal extension into fat developed distant metastases 15 years after diagnosis.
  
  
  CONCLUSIONS
  For LMS involving the skin, it is advisable to recognize and indicate in the histopathology report the depth of dermal and/or subcutaneous extension, since even minimal subcutaneous involvement may be associated with late local recurrences and/or distant metastases, and therefore appropriate and long-term follow-up is needed.
authors.affiliation: Department of Human Pathology and Oncology, University of Florence, Florence, Italy. daniela.massi@unifi.it
authors.forename: Daniela
authors.initials: D
authors.lastname: Massi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Franchi
authors.forename: Llucia
authors.initials: L
authors.lastname: Alos
authors.forename: Martin
authors.initials: M
authors.lastname: Cook
authors.forename: Silvana
authors.initials: S
authors.lastname: Di Palma
authors.forename: Ana B
authors.initials: AB
authors.lastname: Enguita
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.forename: Dmitry V
authors.initials: DV
authors.lastname: Kazakov
authors.forename: Thomas
authors.initials: T
authors.lastname: Mentzel
authors.forename: Michal
authors.initials: M
authors.lastname: Michal
authors.forename: John
authors.initials: J
authors.lastname: Panelos
authors.forename: José L
authors.initials: JL
authors.lastname: Rodriguez-Peralto
authors.forename: Marco
authors.initials: M
authors.lastname: Santucci
authors.forename: Gabrina
authors.initials: G
authors.lastname: Tragni
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Zioga
authors.forename: Angelo Paolo
authors.initials: AP
authors.lastname: Dei Tos
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020405:Dermis / Q000473:pathology; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology* / Q000503:physiopathology; D040521:Subcutaneous Tissue / Q000473:pathology