Primary Cutaneous Leiomyosarcoma

Primary cutaneous leiomyosarcomas are rare malignant tumors. They can occur at any age, but most commonly between the fifth and seventh decade of life. Because of the small number of patients treated, treatment recommendations are still evolving. We report the results of a retrospective study of 12 patients treated for leiomyosarcomas through a thirty year period (from 1973 to 2002). Five males and seven females (mean age, 54.4 years; age range, 22-81 years), more than 58% of the patients were at least 50 years old. The tumors presented mainly as solitary lesions and were located on the upper and lower extremities (seven lesions), trunk (three lesions), and the head and neck (two lesions). The main treatment of choice was surgical wide excision. Clinical follow-up revealed local recurrences in four patients after a period ranging from 3 to 72 months after surgical excision. No distant metastases have been observed in our series. We reviewed published articles. The clinical findings, pathologic examinations and treatments were analyzed. We believe primary cutaneous leiomyosarcoma should be considered biologically benign with regard to distant metastases, despite the malignant histologic appearance. Wide local excision is recommended, and it would seem that narrow margins with a tumor-free plane should be sufficient.