Clinicopathological Study of Primary Superficial
Leiomyosarcomas†
Chairat Burusapat MD*,
Kantang Satayasoontorn MD**, Scott D Nelson MD***
Affiliation :
† Poster presented at the International Surgical Week 2011, Yokohama, Japan, August 28 through September 1, 2011
* Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
** Department of Anatomical Pathology, Army Institute of Pathology, Bangkok, Thailand
*** Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, California, US
Background : Primary superficial leiomyosarcomas (PSL) are rare malignant lesions that are subdivided into cutaneous
and subcutaneous tumors. Primary cutaneous and subcutaneous leiomyosarcomas differ not only as to primary site of
origins, but also to differences in prognosis. Guidelines for management and follow-up are not clearly defined in the literature.
Material and Method: Retrospective review was conducted from the patient’s chart between January 2000 and December
2009. Histopathology, immunohistochemistry, and clinical and surgical records were reviewed.
Results : The authors found five cases of PSL and divided them into two cases of cutaneous leiomyosarcomas and three cases
of subcutaneous leiomyosarcomas. Overall, mean age of the patients was 42.4 years, male: female ratio was 4:1. Clinical
presentations were painless mass. Wide excisions were performed in three cases with 2 cm margins. No local recurrence
was found in the period of follow-up (6 months to 3 years). One case presented with bony metastasis five years after operation.
Conclusion : PSL are rare tumors. Surgical resection remains the main option for curative treatment. Wide excision with at
least 2 cm peripheral margins and a depth that includes subcutaneous tissue and fascia are recommended. The natural
history of these tumors is not clearly defined. All patients should be followed-up for a period of at least five years after
treatments. The authors hoped that further study of these tumors would result in better treatments and follow-up guidelines
to be a benefit to such patients in the future.
Keywords : Primary superficial leiomyosarcomas, Clinicopathology
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