Soft tissue
Smooth muscle
Cutaneous leiomyosarcoma

Author: Vijay Shankar, M.D.

Revised: 31 January 2018, last major update November 2012

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Cutaneous leiomyosarcoma [title] soft tissue

Cite this page: Shankar, V. Cutaneous leiomyosarcoma. website. Accessed March 21st, 2018.
  • More common in men, almost always whites in US (Cancer 2008;113:616)
  • Mean age 40 - 60 years; childhood tumors are rare
Clinical features
  • Either dermal, arising from arrectores pilorum muscle, or subcutaneous, arising from wall of vessel
  • Cutaneous tumors are indolent; subcutaneous tumors may metastasize (Cancer 2007;109:282)
  • Head and neck, extremities, scrotal
Case reports
  • Complete excision with a narrow margin is acceptable for low-grade cutaneous tumors
  • Wide excision with 2 cm lateral margin and one tissue barrier deep margin for low grade and early stage subcutaneous and soft tissue tumors
  • Wide excision for high grade tumors (Plast Reconstr Surg 2005;116:8)
  • Mohs surgery offers tissue sparing with comparable results (Dermatol Surg 2004;30:108)
  • Tumors may recur and occasionally metastasize
Clinical images

Images hosted on other servers:




Microscopic (histologic) description
  • Intersecting fascicles of brightly eosinophilic spindle cells with ovoid to cigar-shaped nuclei
  • Pleomorphism and mitotic figures are common
Microscopic (histologic) images

Images hosted on PathOut servers:

Superficial, courtesy of Mark R. Wick, M.D.

ER, courtesy of Mark R. Wick, M.D.

Images hosted on other servers:

Hip lesion, various images

Leg tumor with osteoclast-like giant cells

Shoulder lesion (at smallpox scar)


Face, SMA

Dermal-based spindle cell tumor

Desmoplasia within the spindle cell tumor

Nuclear pleomorphism



Molecular / cytogenetics description