Primary cutaneous leiomyosarcoma: clinicopathological analysis of 36 cases.
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.
Massi
Daniela
D
Department of Human Pathology and Oncology, University of Florence, Florence, Italy. daniela.massi@unifi.it
Franchi
Alessandro
A
Alos
Llucia
L
Cook
Martin
M
Di Palma
Silvana
S
Enguita
Ana B
AB
Ferrara
Gerardo
G
Kazakov
Dmitry V
DV
Mentzel
Thomas
T
Michal
Michal
M
Panelos
John
J
Rodriguez-Peralto
José L
JL
Santucci
Marco
M
Tragni
Gabrina
G
Zioga
Aikaterini
A
Dei Tos
Angelo Paolo
AP
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