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Cutaneous leiomyosarcoma with myxoid alteration arising in a setting of multiple cutaneous smooth muscle neoplasms
Authors:Jochen Utikal  Georg Haus  Nina Poenitz  Wolfgang Koenen  Walter Back  Edgar Dippel  Alexei Gratchev  Sergij Goerdt
Institution:Department of Dermatology, Venereology and Allergology;, and Department of Pathology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
Abstract:Background:  Cutaneous leiomyomas and leiomyosarcomas are rare tumors that originate from the arrector muscle of hair follicles or the smooth muscle of blood vessels.
Case report:  A 74-year-old male presented with a single, erythematous nodule on the left upper arm. This lesion developed within the excision scar of a piloleiomyoma that had been excised 3 years ago. Additionally, physical examination revealed a tender nodule on the right ear.
Results:  Histological examination showed a cutaneous leiomyosarcoma with myxoid alteration on the upper arm and an angioleiomyoma on the right ear.
Conclusion:  Myxoid leiomyosarcomas have exclusively been reported in the uterus and gastrointestinal tract, but not in the skin. Here, we describe a case of cutaneous leiomyosarcoma with myxoid alteration that developed in the excision scar of a piloleiomyoma and was accompanied by a cutaneous angioleiomyoma in a different location.
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