Leiomiossarcoma cutâneo no tronco

Abstract

Manifestações cutâneas em indivíduos infectados ou com doençasAbstract: O Leiomiossarcoma cutâneo é um tumor maligno que representa 7% dos sarcomas dos tecidos moles, afetando, mais frequentemente, homens entre os 50-70 anos. A localização, no tronco, é atípica, constituindo 10 a 15% dos casos. A radioterapia e o traumatismo prévio têm sido referidos como fatores de risco. Descrevemos um homem de 57 anos, com tumor eritemato-violáceo, indolor, de consistência dura, localizado na região pré-esternal, com cerca de oito meses de evolução. A histopatologia evidenciou tumor maligno de células fusiformes, com núcleos em forma de "charuto", pleomórficos, com alto índice mitótico, ocupando toda a espessura da derme. Estas células expressaram actina do músculo liso, desmina e vimentina e foram negativas para proteína S-100 e pancitoqueratina. Foi efetuada a exérese cirúrgica radical do tumor. Palavras-chave: Imuno-histoquímica; Leiomiossarcoma; Sarcoma Resumo: Cutaneous leiomyosarcoma is a relatively uncommon tumor that accounts for 7% of all soft tissue sarcomas. It occurs more frequently in males between 50-70 years and only 10-15% of cases are located on the trunk. Radiotherapy and previous trauma have been implied as risk factors. We report the case of a 57 year-old male with an eight-month history of a hard painless erythematous-violaceous tumor on the presternal region. Histopathology evidenced a malignant spindle cell tumor, "cigar" shaped, with pleomorphic nuclei and a high mitotic index that occupied the entire dermal thickness. Immunohistochemical staining of the tumor cells was positive for smooth muscle actin, desmin and vimentin and negative for S-100 protein and pan-cytokeratin, which supported the diagnosis of dermal leiomyosarcoma. Radical surgery was performed to remove the tumor.

Cutaneous leiomyosarcoma on the face

“… 3 , 7 There are many differential diagnoses to be considered; immunohistochemistry is essential for an accurate diagnosis ( Table 1 ). 4 …”

“…1 Such classification depends on the percentage of the surface of the tumor that is present in the dermis: more than 90% for dermal tumors and less than 90% for subcutaneous. 4 Dermal tumors usually arise from the arrector pili muscle, whereas the subcutaneous arise from the smooth muscle from the vessels. 1…”

“…Dermal tumors usually reach 2 to 3cm in diameter, while subcutaneous tumors grow larger than 2cm. 1 , 3 , 4 Pain, edema, pruritus and paresthesia could be associated. 1 , 4 These tumors occur on any part of the body, but rarely affect the face.…”

“…1 , 3 , 4 Pain, edema, pruritus and paresthesia could be associated. 1 , 4 These tumors occur on any part of the body, but rarely affect the face. 1 , 3 …”

“…Subcutaneous tumors, the most common, recur more frequently (50% to 70%) and show metastasis in 30% to 60% of cases, related to the size and degree of differentiation of the lesion. 1 , 3 , 4 …”