Primary cutaneous diffuse leiomyosarcoma with desmoplasia

Australas J Dermatol. 2006 Nov;47(4):291-5. doi: 10.1111/j.1440-0960.2006.00298.x.

Abstract

A 65-year-old man presented with an indurated plaque over his left cheek and left neck. An initial punch biopsy of skin showing increased smooth muscle bundles was consistent with a diagnosis of smooth muscle hamartoma. A second incisional skin biopsy revealed a well-differentiated smooth muscle proliferation invading into the dermis and subcutaneous fat in a diffusely infiltrative pattern and with a desmoplastic component, suggesting a diagnosis of desmoplastic leiomyosarcoma. Resection of the tumour confirmed the presence of a cytologically low grade leiomyosarcoma with an insidious infiltrative growth pattern. This rare pattern of diffuse leiomyosarcoma is important to recognize as the histological features are subtle and may potentially constitute a pitfall in histological diagnosis in a small biopsy specimen. In addition, our case illustrates overlapping morphology between diffuse and desmoplastic types of leiomyosarcoma.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Cheek / pathology
  • Combined Modality Therapy
  • Desmosomes / pathology
  • Diagnosis, Differential
  • Humans
  • Leiomyosarcoma / diagnosis*
  • Leiomyosarcoma / pathology
  • Leiomyosarcoma / radiotherapy
  • Leiomyosarcoma / surgery
  • Male
  • Neck / pathology
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / radiotherapy
  • Skin Neoplasms / surgery