Cutaneous Leiomyosarcoma: A Tumor of the Head and Neck

Abstract

have indicated no significant interest with commercial supporters. Case ReportA 68-year-old gentleman presented to the Veterans Administration dermatology clinic with a severalweek history of a new growth on the left ear ( Figure 1). The lesion was asymptomatic and the patient denied previous treatment to the area. He was feeling constitutionally well. Physical examination revealed a 1.0-cm pink to brown shiny opalescent crusted nodule on the left ear, spanning the midhelix and antihelix. Adenopathy was not appreciated. The initial clinical differential diagnosis included basal cell carcinoma, amelanotic malignant melanoma, and Merkel cell carcinoma. A deep shave biopsy was performed.Histologic evaluation revealed an atypical spindle cell proliferation with pleomorphic nuclei and scattered atypical mitoses infiltrating the dermis (Figures 2 and 3). Immunohistochemistry showed strong positivity for smooth muscle actin and vimentin. Desmin was focally positive. Pankeratin, S100, and Mart-1 staining were negative.A histologic diagnosis of cutaneous leiomyosarcoma was made. Excision of the primary lesion was performed. Lateral surgical margins extended 5 mm beyond the clinical boundary of the lesion, and the deep margin extended to the posterior aspect of the auricular cartilage. Clear surgical margins were confirmed histologically. A porcine xenograft Figure 1. Clinical photograph.Figure 2. Low-power magnification demonstrates an atypical spindle cell proliferation infiltrating the entire dermis. H&E; original magnification, 4 Â .

A Rare Diagnosis in the Head and Neck Region

“…Regional nodal metastasis is less common. 6 The cause of death in LMS has been reported to be due to distant metastasis as in this case. 2 Further prospective studies on systemic treatment options in preventing distant metastasis and/or prolonging survival are needed.…”

“…6 However, there may be differences in biological behavior. So, RT and chemotherapy adjuvant to surgery are recommended by the authors, although they are controversial.…”

Cutaneous Malignancies of the Perineum

“…77 SLM tends to affect patients between 50 and 70 years old, with predilection for the extensor surfaces of extremities and head and neck (cutaneous type). 78 Sarcomas in general are rare, accounting for just 0.7% of all malignancies, with 2% to 3% of those being classified as SLM. 79,80 Women are affected twice as often as men; this sex preference may be explained by the smooth muscle proliferation that occurs in response to increased estrogen levels.…”

A Case Report On Cutaneous Leiomyosarcoma with Review of Literatures

“…Leiomyosarcoma of the skin includes superficial leiomyosarcoma arising from cutaneous structures and metastatic leiomyosarcoma that derives from distant visceral sites 4 .…”

“…Mohs micrographic operation with narrow surgical margins is another method of treatment to ensure complete tumour removal. This procedure showed a considerable reduction in the risk of local recurrence, preservation of normal tissue and ensures amore rewarding functional and aesthetic result 4,17 . Cryosurgery has also been used in elderly patient 10 .…”