Dermal Leiomyosarcoma: A Misnomer?

LEIOMYOSARCOMAS THAT ARISE in the dermis are uncommon. Their diagnosis is difficult, in part, because this entity may not be considered in the differential diagnosis of spindle cell tumors in this location, and in part, because the lesions may be confused with fibrous histiocytomas, melanocytic proliferations, postirradiation fibromatoses, reactive lesions, vascular lesions—particularly Kaposi’s sarcoma, Schwann cell tumors and others. In reviewing the literature, we believe that some of the previously published cases of leiomyosarcomas of the skin probably represented other entities. In addition, it seems unfortunate that previous comprehensive reviews of leiomyosarcomas of the skin have tended to include those of the deeper soft tissues along with those arising in the dermis.