Article

Primary cutaneous diffuse leiomyosarcoma with desmoplasia

Skin and Cancer Foundation Australia, Darlinghurst, New South Wales, Australia.
Australasian Journal of Dermatology (Impact Factor: 0.98). 12/2006; 47(4):291-5. DOI: 10.1111/j.1440-0960.2006.00298.x
Source: PubMed

ABSTRACT A 65-year-old man presented with an indurated plaque over his left cheek and left neck. An initial punch biopsy of skin showing increased smooth muscle bundles was consistent with a diagnosis of smooth muscle hamartoma. A second incisional skin biopsy revealed a well-differentiated smooth muscle proliferation invading into the dermis and subcutaneous fat in a diffusely infiltrative pattern and with a desmoplastic component, suggesting a diagnosis of desmoplastic leiomyosarcoma. Resection of the tumour confirmed the presence of a cytologically low grade leiomyosarcoma with an insidious infiltrative growth pattern. This rare pattern of diffuse leiomyosarcoma is important to recognize as the histological features are subtle and may potentially constitute a pitfall in histological diagnosis in a small biopsy specimen. In addition, our case illustrates overlapping morphology between diffuse and desmoplastic types of leiomyosarcoma.

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