In this multicenter analysis of patients with LCAs, risk of rupture correlated with increasing tumor size and recent hormone use. Rupture is associated with greater need for preoperative blood transfusion and major hepatic resection. These data suggest that patients with asymptomatic LCAs approaching 4 cm and those requiring hormonal therapy should undergo surgical therapy.
Introduction
Cutaneous leiomyosarcoma (LMS) is a rare dermal-based tumor for which treatment algorithms have been poorly defined. We report our single institution experience treating cutaneous LMS using a median of a 1 cm margin for resection.
Methods
An IRB approved review of patients with cutaneous LMS from 2005-2010 was performed with outcomes reported.
Results
33 patients with cutaneous LMS were treated, 76% were male, 97% were Caucasian with a median age of 63.5 years. 67% of tumors were located on the extremities. Pre-operative staging was negative for distant metastasis in all patients. 88% of tumors were low grade with a median tumor size of 1.3 cm. 100% of tumors tested for smooth muscle actin were positive. A majority (94%) of patients underwent primary surgical resection with a median margin of 1 cm. Final resection margin was negative in 32/33 (97%). Adjuvant radiotherapy was used in 15%. There were no recurrences or metastastic spread and 100% were alive at last follow up, median of 15.5 months.
Conclusions
Cutaneous LMS is primarily a low-grade malignancy affecting elderly male Caucasians. Good oncologic control and an excellent outcome are possible with a 1 cm resection margin in the vast majority of cases.
Despite multimodal treatment, DSRCT is associated with dismal outcomes. Facilities familiar with treating this uncommon disease may experience superior outcomes.
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