Salemis Nikolaos S
Department of Surgery, Army Veterans General Hospital, Athens, Greece.
J Nat Sci Biol Med. 2013 Jan;4(1):238-42. doi: 10.4103/0976-9668.107316.
Superficial leiomyosarcomas are rare malignant smooth-muscle tumors accounting for 4-6.5% of all soft-tissue sarcomas, less than 2-3% of cutaneous soft-tissue neoplasms and 0.04% of all cancers. They are divided into cutaneous or dermal and subcutaneous leiomyosarcomas. Subcutaneous tumors have been reported to be associated with an increased risk of local recurrences and distant metastases, compared to their cutaneous counterparts. In this study, we describe a rare case of a recurrent subcutaneous trunk leiomyosarcoma in a 68-year-old male patient. Local recurrence developed two years after the complete surgical resection with wide margins and adjuvant postoperative radiotherapy. The management of the patient is discussed along with a review of the literature. We conclude that subcutaneous leiomyosarcoma is a rare clinical entity which may be associated with an atypical clinical presentation. Physicians should be aware of the misleading features of this tumor in order to avoid delay in diagnosis and treatment. Early complete surgical resection with wide margins of at least 2 cm is the cornerstone of treatment and has been reported to mostly influence the prognosis. However, the tumor has a high tendency to recur locally and metastasize. Recurrence may develop despite wide resection and radiotherapy. Long-term follow-up is mandatory.
浅表性平滑肌肉瘤是罕见的恶性平滑肌肿瘤，占所有软组织肉瘤的4 - 6.5%，占皮肤软组织肿瘤的比例不到2 - 3%，占所有癌症的0.04%。它们分为皮肤或真皮及皮下平滑肌肉瘤。据报道，与皮肤型相比，皮下肿瘤局部复发和远处转移的风险增加。在本研究中，我们描述了一例68岁男性患者复发性躯干皮下平滑肌肉瘤的罕见病例。在进行了切缘广泛的完全手术切除及辅助性术后放疗两年后出现了局部复发。本文结合文献复习对该患者的治疗进行了讨论。我们得出结论，皮下平滑肌肉瘤是一种罕见的临床实体，可能具有非典型的临床表现。医生应了解该肿瘤的误导性特征，以避免诊断和治疗延误。早期进行至少2厘米切缘广泛的完全手术切除是治疗的基石，据报道这对预后影响最大。然而，该肿瘤具有较高的局部复发和转移倾向。尽管进行了广泛切除和放疗仍可能复发。必须进行长期随访。
