Cutaneous leiomyosarcoma arising in a smallpox scar.docVIP

Poletal.WorldJournalofSurgicalOncology2012,10:148 /content/10/1/148 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT OpenAccess Cutaneousleiomyosarcomaarisinginasmallpox scar RobertAPol ,HildeDannenberg ,Jan-LukasRobertus andRobertJvanGinkel1 1* 1 2 Abstract Background:Cutaneousleiomyosarcoma(CLM)isaveryraresmoothmuscletumourthataccountsforabout 2–3%ofallsuperficialsofttissuesarcomas.Althoughthedevelopmentofvariousmalignanciesinscartissueiswell known,wereportthefirstcaseofaCLMdevelopinginasmallpoxscar. Casepresentation:A66-year-oldmanpresentedwithapainless,slow-growinglumpinasmallpoxscaronhisleft shoulder.Histologicalbiopsiesshowedthelesiontobeaprimary,well-differentiatedcutaneousleiomyosarcoma.A CTscanofthethoraxwasconducted,whichshowednosignsofmetastases.Thecompletelesionwasthen surgicallyexcised,andhistopathologicalexaminationrevealedaradicallyexcisedcutaneoustypeleiomyosarcoma After13months’reviewthepatientwasdoingwellwithnoevidenceoftumourrecurrence. Conclusions:ThisisthefirstreportofaCLMarisinginasmallpoxscar.Althoughtheextendedtimeinterval betweenscarringandmalignantchangesmakesitdifficulttoadvisestrictfollow-upforpatientswithsmallpox scars,oneshouldbeawarethatatypicalchangesand/orsymptomsoccurringinasmallpoxscarcouldpotentially meanmalignanttransformation. Keywords:Cutaneousleiomyosarcoma,Scar,Smallpox,Treatment Background Casepresentation Cutaneousleiomyosarcoma(CLM)isaveryraresmooth A 66-year-old man wasreferredto our outpatient clinic muscle tumour that accounts for about 2–3% of all byhisdermatologist.Hepresentedwithapainless,slow- superficialsofttissuesarcomas[1].CLMpresentsinper- growing lump in a small pox scar on his left shoulder sonsofallagesbutwithapeakoccurrencebetween50– (Figure1).Histologicalbiopsiesweretakenandreviewed 70yearsofage.Itmayoccuranywhereonthebodywith by a specialised panel for soft tissue tumours, which apredilectionforthelimbs.ClinicalappearanceofCLM showed the lesion to be a primary, well-differen