Skin nonmelanocytic tumor
Cutaneous muscle tumors & hamartomas
Leiomyoma
Author: Christopher S. Hale, M.D.
Last author update: 1 September 2012
Last staff update: 9 April 2024 (update in progress)
Copyright: 2001-2024, PathologyOutlines.com, Inc.
PubMed search: leiomyoma [title] skin free full text[sb]
Table of Contents
Definition / general | Clinical features | Case reports | Treatment | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Molecular / cytogenetics description | Differential diagnosisCite this page: Hale C. Leiomyoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticleiomyoma.html. Accessed April 17th, 2024.
Definition / general
- Divided into lesions of nipple or scrotum, pilar leiomyoma or solitary angioleiomyoma (vascular leiomyoma) usually in subcutis
- May be very painful
- Familial cutaneous leiomyomatosis (Reed syndrome):
- Due to mutation in fumarate hydratase, may be associated with renal cell carcinoma (Dermatol Online J 2005;11:21)
Clinical features
- Arises from arrector pili muscles
- Superficial, small, multiple, painful
- May be due to hereditary leiomyomatosis and renal cell cancer syndrome (J Urol 2007;177:2074)
- May be associated with germline mutations in the fumarate hydratase gene (Nat Genet 2002;30:406, Cancer Genet Cytogenet 2008;183:83)
Case reports
- 51 year old woman with multiple cutaneous and uterine leiomyomatosis (Dermatol Online J 2005;11:21)
- 79 year old man with hereditary leiomyomatosis and renal cell carcinoma syndrome (Dermatol Online J 2008;14:16)
Treatment
- Avoidance of cold
- Possibly nifedipine, nitroglycerine, phenoxybenzamine (block smooth muscle contraction) (Dermatol Online J 2005;11:21)
- Possibly botulinum toxin type A (Dermatology 2009;218:44)
- Possibly excision with dermal skin template for multiple tumors, carbon dioxide laser ablation (J Cutan Med Surg 2009;13:102)
Clinical images
Images hosted on other servers:
Multiple asymptomatic, hyperkeratotic nodules on leg
Gray-brown macules on face
Trunk
Microscopic (histologic) description
- Intersecting smooth muscle fascicles
- May have scattered bizarre hyperchromatic nuclei (symplastic leiomyoma)
- No atypia, no mitotic activity, no necrosis
- Pilar leiomyoma:
- Dermal intersecting fascicles of eosinophilic spindle cells with plump, cigar shaped nuclei with dermal collagen bundles
Microscopic (histologic) images
Contributed by Angel Fernandez-Flores, M.D., Ph.D.
Various images
Molecular / cytogenetics description
- Almost all patients with multiple skin leiomyomas have germline fumarate hydratase mutation (Arch Dermatol 2005;141:199)
Differential diagnosis
