{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:25:31Z","timestamp":1789590331719,"version":"build-2803163510"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Abstract<\/jats:p>\n               <jats:p>Primary cutaneous leiomyosarcoma (LMS) is a rare soft tissue tumour type with two subtypes, dermal and subcutaneous. As deeper tumours confer a worse prognosis, they require a more aggressive approach. Conversely, a more conservative surgical approach for dermal LMS has been suggested. Few studies have comprehensively reported both clinical surgical and histological excision margins. Therefore, we sought to provide margin recommendations based on our experience and review of the existing literature. We undertook a retrospective case-note review (1998\u20132019) of cutaneous LMS management to establish histological\/surgical margins using pathology\/electronic patient records. The diagnosis was made and classified by an experienced dermatopathologist according to the World Health Organization classification. In the dermal LMS cohort (n = 35), mean peripheral and deep histological margins were 5.4\u2005mm (range 0.5\u201320) and 5.6\u2005mm (range 0.1\u201314.5), respectively. The incomplete excision rate was 31% (11 of 35). There were no recurrences. In the subcutaneous LMS cohort (n = 10), mean peripheral and deep histological margins were 5.7\u2005mm (range 0.2\u201314) and 1.1\u2005mm (range 0.2\u20131.7), respectively. The incomplete excision rate was 40% (4 of 10). The recurrence rate was 20% (2 of 10) despite achieving histological clearance after 1\u2005year. One lung metastasis occurred 1\u2005year following an adequately excised primary scalp LMS. Thus, for dermal LMS we propose a clinical margin of 5\u201310\u2005mm (depending on lesion size) at the initial excision or at scar re-excision following involved\/close histological peripheral and\/or deep margins (i.e. &amp;lt; 1\u2005mm). For subcutaneous LMS, we suggest a clinical margin of 15\u201320\u2005mm (depending on lesion size) to achieve a peripheral histological clearance of 10\u2005mm and negative deep margin (i.e. &amp;gt; 1\u2005mm), down to the periosteum\/fascia\/muscle according to anatomical site. If this is not achieved, a re-excision would be recommended. However, prospective studies are needed for optimal guidance.<\/jats:p>","DOI":"10.1093\/ced\/llad276","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T19:36:47Z","timestamp":1692387407000},"page":"2-8","source":"Crossref","is-referenced-by-count":7,"title":["Cutaneous leiomyosarcoma: a retrospective review of\u00a045\u00a0cases"],"prefix":"10.1093","volume":"49","author":[{"given":"Sabrina","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Dermatology, Oxford University Hospitals NHS Foundation Trust , Oxford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Asher","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Oxford University Hospitals NHS Foundation Trust , Oxford , UK"},{"name":"Department of Pathology, Cardiff and Vale University Health Board , Cardiff , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Oxford University Hospitals NHS Foundation Trust , Oxford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-5412","authenticated-orcid":false,"given":"Rubeta N","family":"Matin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Oxford University Hospitals NHS Foundation Trust , Oxford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"2023122001323668900_llad276-B1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1684\/ejd.2015.2681","article-title":"Primary cutaneous and subcutaneous leiomyosarcomas: evolution and prognostic factors","volume":"26","author":"Aneiros-Fernandez","year":"2016","journal-title":"Eur J Dermatol"},{"key":"2023122001323668900_llad276-B2"},{"key":"2023122001323668900_llad276-B3","volume-title":"WHO Classification of Skin Tumours","author":"Elder","year":"2018","edition":"4th edn"},{"key":"2023122001323668900_llad276-B4","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/j.1524-4725.1996.tb00609.x","article-title":"Leiomyosarcoma of the skin. Treatment of 34 cases","volume":"22","author":"Bernstein","year":"1996","journal-title":"Dermatol Surg"},{"key":"2023122001323668900_llad276-B5","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ad.2018.06.012","article-title":"Leiomyosarcoma and pleomorphic dermal sarcoma: guidelines for diagnosis and treatment","volume":"110","author":"Llombart","year":"2019","journal-title":"Actas Dermosifiliogr (Engl Ed)"},{"key":"2023122001323668900_llad276-B6","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/ajd.13307","article-title":"Cutaneous leiomyosarcoma: dermal and subcutaneous","volume":"61","author":"Wong","year":"2020","journal-title":"Australas J Dermatol"},{"key":"2023122001323668900_llad276-B7","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1111\/ijd.14705","article-title":"Leiomyosarcoma of the skin: review of the literature with an emphasis on prognosis and management","volume":"59","author":"Kazlouskaya","year":"2020","journal-title":"Int J Dermatol"},{"key":"2023122001323668900_llad276-B8","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.abd.2020.10.003","article-title":"Cutaneous leiomyosarcoma: a 20-year retrospective study and review of the literature","volume":"96","author":"Queir\u00f3s C","year":"2021","journal-title":"An Bras Dermatol"},{"key":"2023122001323668900_llad276-B9","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1002\/jso.26262","article-title":"Treatment outcome of superficial leiomyosarcoma","volume":"123","author":"Wellings","year":"2021","journal-title":"J Surg Oncol"},{"key":"2023122001323668900_llad276-B10","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.ad.2017.08.005","article-title":"Clinical and histopathologic findings of cutaneous leiomyosarcoma: correlation with prognosis in 12 patients","volume":"109","author":"Rodr\u00edguez-Lomba","year":"2018","journal-title":"Actas Dermosifiliogr"},{"issue":"Suppl. 1","key":"2023122001323668900_llad276-B11","article-title":"Atypical intradermal smooth muscle neoplasm: analysis of 11 cases","volume":"79","author":"O\u00f1ate","year":"2018","journal-title":"J Am Acad Dermatol"},{"key":"2023122001323668900_llad276-B12","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/PAI.0b013e31825f4af2","article-title":"Atypical intradermal smooth muscle neoplasms (formerly cutaneous leiomyosarcomas): case series, immunohistochemical profile and review of the literature","volume":"21","author":"Hall","year":"2013","journal-title":"Appl Immunohistochem Mol Morphol"},{"key":"2023122001323668900_llad276-B13","first-page":"1434","article-title":"Patterns of infiltration and local recurrences of various types of cutaneous sarcomas following three-dimensional histology","volume":"16","author":"Welsch","year":"2018","journal-title":"J Dtsch Dermatol Ges"},{"key":"2023122001323668900_llad276-B14","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1097\/SAP.0000000000001005","article-title":"Cutaneous leiomyosarcoma: the clinical experience of Taipei Veterans General Hospital revisited","volume":"78","author":"Liao","year":"2017","journal-title":"Ann Plas Surg"},{"key":"2023122001323668900_llad276-B15","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/j.jaad.2014.07.020","article-title":"Leiomyosarcoma of the skin: clinical, histopathologic, and prognostic factors that influence outcomes","volume":"71","author":"Winchester","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"2023122001323668900_llad276-B16","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1177\/107327481302000408","article-title":"Cutaneous leiomyosarcoma: treatment and outcomes with a standardized margin of resection","volume":"20","author":"Deneve","year":"2013","journal-title":"Cancer Control"},{"key":"2023122001323668900_llad276-B17","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/PAS.0b013e31820e6093","article-title":"Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous \u2018leiomyosarcoma\u2019","volume":"35","author":"Kraft","year":"2011","journal-title":"Am J Surg Pathol"},{"key":"2023122001323668900_llad276-B18","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1111\/j.1365-2559.2009.03471.x","article-title":"Primary cutaneous leiomyosarcoma: clinicopathological analysis of 36 cases","volume":"56","author":"Massi","year":"2010","journal-title":"Histopathology"},{"key":"2023122001323668900_llad276-B19","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/j.1600-0560.2009.01405.x","article-title":"Superficial leiomyosarcoma: a clinicopathologic review and update","volume":"37","author":"Fauth","year":"2010","journal-title":"J Cutan Pathol"},{"key":"2023122001323668900_llad276-B20","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/j.jaad.2010.11.051","article-title":"Mohs micrographic surgery for the treatment of cutaneous leiomyosarcoma","volume":"64","author":"Starling","year":"2011","journal-title":"J Am Acad Dermatol"},{"key":"2023122001323668900_llad276-B21","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/01.PRS.0000169711.70525.10","article-title":"Management of superficial leiomyosarcoma: a retrospective study of 10 cases","volume":"116","author":"Tsutsumida","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"2023122001323668900_llad276-B22","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1002\/jso.20009","article-title":"The prognostic significance of margin width for extremity and trunk sarcoma","volume":"85","author":"McKee","year":"2004","journal-title":"J Surg Oncol"},{"key":"2023122001323668900_llad276-B23","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1002\/1097-0142(19810101)47:1<156::AID-CNCR2820470127>3.0.CO;2-#","article-title":"Leiomyosarcoma of the skin and subcutaneous tissue","volume":"47","author":"Fields","year":"1981","journal-title":"Cancer"},{"key":"2023122001323668900_llad276-B24","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.currproblcancer.2015.07.006","article-title":"Current approaches to cutaneous sarcomas: dermatofibrosarcoma protuberans and cutaneous leiomyosarcoma","volume":"39","author":"Glazer","year":"2015","journal-title":"Curr Probl Cancer"}],"container-title":["Clinical and Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ced\/advance-article-pdf\/doi\/10.1093\/ced\/llad276\/52789560\/llad276.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/49\/1\/2\/54647673\/llad276.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/49\/1\/2\/54647673\/llad276.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T01:33:17Z","timestamp":1703035997000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ced\/article\/49\/1\/2\/7245994"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,18]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,8,18]]},"published-print":{"date-parts":[[2023,12,19]]}},"URL":"https:\/\/doi.org\/10.1093\/ced\/llad276","relation":{},"ISSN":["0307-6938","1365-2230"],"issn-type":[{"value":"0307-6938","type":"print"},{"value":"1365-2230","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1]]},"published":{"date-parts":[[2023,8,18]]}}}