Melanin Pigment Uptake Within Paget Cells

Cutaneous leiomyosarcoma typically presents as solitary, well‐circumscribed, firm plaques or nodules. We describe a case of cutaneous leiomyosarcoma clinically presenting as a skin tag on the thigh of a 50‐year‐old male. Histological examination of the lesion revealed a dome‐shaped tumor with interlacing fascicles of smooth muscle with pleomorphism, cellular atypia and multiple mitoses. Malignant tumors may rarely present as a skin tag, and these are most frequently basal cell carcinomas. We are unaware of previously reported leiomyosarcoma clinically presenting as a skin tag. This case suggests that solitary, wide‐based, papilloma‐like lesions or skin tags should be submitted for histologic examination to rule out malignancy.