Current approaches to cutaneous sarcomas: Dermatofibrosarcoma protuberans and cutaneous leiomyosarcoma

Cutaneous leiomyosarcoma: a 20-year retrospective study and review of the literature

“…Classic recommendations suggested aggressive surgeries with margins of 3–5 cm; however, similar results have recently been observed with more conservative surgeries (margins of 1 cm), without higher local recurrence rates and with improved morbidity. 7 The deep margin should reach up to the fascia, and in more infiltrating cases the muscle should be included. 7 Evaluation of surgical margins is a key-point in establishing the probability of future recurrence.…”

“… 7 The deep margin should reach up to the fascia, and in more infiltrating cases the muscle should be included. 7 Evaluation of surgical margins is a key-point in establishing the probability of future recurrence. Therefore, all pathology reports should include such data, as well as the shortest distance to the nearest surgical margin.…”

“…It is estimated that up to 20% of patients may require repeated excisions to achieve negative margins. 7 Mohs micrographic surgery may be of particular interest in cutaneous LMS. 6 …”

Red crateriform tumour on the scalp

“…Dermal LMS usually affects men between the fifth to seventh decades of life, and only 23% of cases arise in the head and neck area. This subtype has a more ‘benign’ behaviour, with local recurrence in 35% of cases and distant metastasis in up to 14%; the latter percentage increases with extension to the subcutis . Surgical resection with wide margins is the standard of care and primary management, but the precise ‘recommended’ margins are not clear from the literature .…”

“…Nuclear hyperchromasia, pleomorphism and typical and/or atypical mitotic figures are present. Immunohistochemical evaluation usually shows positivity for SMA, muscle actin, desmin and h‐caldesmon immunostaining …”