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Abstract
BackgroundCutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2–3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar.Case presentationA 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months’ review the patient was doing well with no evidence of tumour recurrence.ConclusionsThis is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.
Highlights
Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2–3% of all superficial soft tissue sarcomas
This is the first report of a CLM arising in a small pox scar
The extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation
Summary
This report describes the first case of CLM formation in a small pox scar. Primary CLM can be a diagnostic challenge and adequate surgical excision is the appropriate treatment. Based on this one case, regular checks cannot be recommended. Author details 1Department of Surgery, University Medical Center Groningen, P.O. Box 30 001, Groningen, RB 9700, The Netherlands. JLR drafted part of the manuscript, critically revised its final form, and provided Figures 2 and 3. RJG critically revised the final manuscript and was responsible for the primary care and outpatient controls. All authors read and approved the final manuscript
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