Cutaneous leiomyosarcoma arising in a smallpox scar.
BACKGROUND
Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2-3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar.


METHODS
A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months' review the patient was doing well with no evidence of tumour recurrence.


CONCLUSIONS
This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.
Department of Surgery, University Medical Center Groningen, P,O, Box 30 001, Groningen RB 9700, The Netherlands. pol.chirurgie@gmail.com
Robert A
RA
Pol
Hilde
H
Dannenberg
Jan-Lukas
JL
Robertus
Robert J
RJ
van Ginkel
D000368:Aged; D002921:Cicatrix / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology*; D008297:Male; D016609:Neoplasms, Second Primary / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D012899:Smallpox / Q000473:pathology*