Superficial Leiomyosarcoma Treated With Mohs Micrographic Surgery
The overall cure rate of leiomyosarcoma treated by MMS is 87%
Leiomyosarcoma (LMS) is a rare cutaneous malignancy with an infiltrative growth pattern and high risk of local recurrence (30‑45%) with conventional wide excision. Mohs micrographic surgery (MMS) may offer an improved cure. Three cases of LMS were excised using MMS. Two cutaneous tumors located on the trunk and arm were easily removed and have not recurred. The third tumor on the leg of an immunosuppressed patient demonstrated deep soft‑tissue invasion that developed subsequent cutaneous metastases but no recurrence adjacent to the primary site. The patient remains disease free at 36 months after amputation below the knee. A total of 15 cases of LMS treated by MMS are reported in the literature, with an aggregate recurrence rate of 13%. The overall cure rate of leiomyosarcoma treated by MMS is 87%, which compares favorably to wide excision and offers the advantage of tissue sparing. Immunosuppression may promote aggressive tumor behavior. Deeply invasive tumors may result in cutaneous or distant metastases regardless of the method of excision.
The 87% cure rate supports Mohs micrographic surgery as a less invasive, tissue‑sparing alternative to conventional wide excision for superficial leiomyosarcoma.
Evidence level: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.
Related signals
- First-Line Chemotherapy Regimens for Advanced and Metastatic Leiomyosarcoma: Doxorubicin vs. Gemcitabine—A Systematic Review
- Leiomyosarcoma
- Eribulin versus dacarbazine in patients with leiomyosarcoma: subgroup analysis from a phase 3, open-label, randomised study
- Lineage-defined leiomyosarcoma subtypes emerge years before diagnosis and determine patient survival
- Immunotherapy-based salvage therapy in advanced soft tissue sarcoma after first-line chemotherapy: a retrospective single-center analysis with emphasis on undifferentiated pleomorphic sarcoma