Cutaneous leiomyosarcoma arising in a smallpox scar

Abstract

BackgroundCutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2–3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar.Case presentationA 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months’ review the patient was doing well with no evidence of tumour recurrence.ConclusionsThis is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.

Primary cutaneous leiomyosarcoma of the flank: Case report and review

“…Cutaneous LMS have a better prognosis compared with the subcutaneous subtype with less local recurrence rates (30-50% versus up to 70%) and uncommon metastasis (Pashaei et al, 2005). Principal poor prognostic factors include tumor size P5 cm, deep location with fascia involvement and high malignancy grade (APol et al, 2012).…”

“…Due to their infrequency and unspecific clinical presentation, the diagnosis of LMS is usually delayed (APol et al, 2012). Tumor localization and its expansion to the adjacent tissues may limit surgical excision and determine mainly the prognosis.…”

On the diagnosis and treatment of cutaneous and soft tissue tumours misdiagnosed as scars: Lessons from four cases

“…Recurrent injury, chronic irritation, chronic ulceration, and subsequent chronic inflammation may lead to squamous cell or basal cell carcinomas. While the emergence and development of sarcomas such as leiomyosarcoma and myxofibrosarcoma from scarred areas are uncommon, they have been reported in recent years …”

“…While the emergence and development of sarcomas such as leiomyosarcoma and myxofibrosarcoma from scarred areas are uncommon, they have been reported in recent years. 7,8 The extent to which chronic irritation of scarred areas causes lesions to become tumours and if tumours mimic scar appearances are unknown. Certain sarcomas, such as DFSPs, often have a trauma history, and their progression and appearance can be mimic that of scars.…”

Cutaneous leiomyosarcoma on the trunk: an unusual presentation with an aggressive course � case report and review of literature

“…Histogenesis remains unclear but physical trauma, radiation exposure and medical history of leiomyoma are suspected to be the most predisposing factor [1]. Association with burn and small pox scars was reported too [2, 3]. PCL mainly affects patients in the 5 th and 6 th decade of life with a male preference [4-6].…”