Primary cutaneous diffuse leiomyosarcoma with desmoplasia
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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- "However, in contrast to skin of other sites, it also contains lactiferous ducts that connect to the mammary parenchyma. Table 3 summarizes the clinical features, the treatment and outcome of primary leiomyosarcoma at the nipple-areola complex, the skin of other sites and the mammary parenchyma that reported in literature (Choy et al., 2006; Holst et al., 2002; Lonsdale and Widdison, 1992; Markaki et al., 2003; Uğraş et al., 1997). Tumors of these various sites had similar cytological and architectural characteristics. "
ABSTRACT: Primary leiomyosarcoma of the nipple-areola complex is extremely rare. Less than ten such cases have been reported in English literature so far. Herein we describe a 52-year-old female presenting with a 1.5 cmx1.1 cmx0.7 cm nodular lesion over her left nipple, and leiomyosarcoma was proved by pathological examination of the excised specimen. Positron emitted tomogram (PET) revealed no abnormal signal other than the primary site. Microscopically, this poorly circumscribed tumor was composed of interlacing bundles of smooth muscle cells with bizarre and pleomorphic nuclei, as well as prominent nucleoli. Its mitotic count was up to 7 mitoses per 10 high power fields (HPF). Immunohistochemical study of tumor cells revealed positive stain for alpha-smooth muscle actin and vimentin; and negative for cytokeratin, CD34 and S-100. Left simple mastectomy was undertaken and no residual mass lesion was noted on the resected specimen. Related literatures about the diagnosis and treatment for breast leiomyosarcoma will be presented here.Journal of Zhejiang University SCIENCE B 03/2008; 9(2):109-13. DOI:10.1631/jzus.B0720246 · 1.29 Impact Factor
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ABSTRACT: Intradermal melanoma diagnosis poses a great deal of confusion on many occasions since it can mimic almost any tumour within the dermis. In part I, the different features of intraepidermal mimics were discussed. In this part, there is discussion of the clinical, cytomorphological and immunohistochemical features of intradermal mimics of melanoma and how to distinguish these conditions from melanoma. There is also a description of the ultrastructural features of some of these conditions that may help to distinguish melanoma from its mimics. It is hoped that this approach, together with part I of the non-melanocytic mimics of melanoma, will aid in better overall understanding of melanoma and its mimics.Journal of clinical pathology 12/2008; 62(4):290-307. DOI:10.1136/jcp.2008.062927 · 2.55 Impact Factor
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ABSTRACT: Malignant and borderline-malignant neoplasms of the dermis can pose diagnostic challenges. Because these tumors can share similar clinical and histologic features, including a predominantly spindle cell morphology, the pathologist must be familiar with these entities in order to facilitate accurate diagnosis, as treatment for these tumors may be different. We review several of these lesions with respect to clinical and histologic features: desmoplastic melanoma, spindle cell carcinoma, spindle cell atypical fibroxanthoma, dermatofibrosarcoma protuberans, and cutaneous leiomyosarcoma.