Solitary skin nodule in a young male: a case of cutaneous leiomyosarcoma

ABSTRACT

A case of cutaneous leiomyosarcoma in a young male is reported and literature reviewed. A 31-year old Asian male presented to the Dermatology OP with the complaint of a solitary swelling in the posterior aspect of the upper third of left thigh. On examination a skin colored nodule of about 1.6 cm diameter was found. It was dome-shaped, firm to hard, fixed to the skin and tender. An excision biopsy was done and the specimen was sent for HPE study. The result of biopsy was reported as cutaneous leiomyosarcoma. Cutaneous leiomyosarcomas are uncommon malignant soft tissue tumors which arise from the smooth muscles of the skin, the superficial type from arectorpilori muscle and the deep from the vascular wall of the capillaries. They comprise about 2-3% of soft tissue sarcomas. Our patient was an apparently healthy male who wanted to remove a small swelling in the thigh which had recently appeared. There were no remarkable clinical features to make a clinical diagnosis of cutaneous leiomyosarcoma. It was only when the skin biopsy was done that the histopathological examination revealed a cutaneous leiomyosarcoma. Hence a histopathological examination is most useful and necessary for the diagnosis of soft tissue tumors. The prognosis of the condition can be predicted using criteria laid down by Jenson et al. Long term follow up is necessary because of the risk of recurrence and metastasis