{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:34:28Z","timestamp":1781660068056,"version":"3.54.5"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>Subcutaneous leiomyosarcoma (LMS) is a rare, poorly understood variant. The current literature on the subject is sparse, consisting of isolated case reports and small clinicopathologic studies compromised by the inclusion of both its more common and indolent counterpart, cutaneous LMS (atypical intradermal smooth muscle neoplasm), as well as highly aggressive deep-seated tumors. Thus, precise clinicopathologic characterization is limited. Cases of subcutaneous LMS reviewed at the University of Michigan and Cleveland Clinic from 1994 to 2022 were included in this retrospective study. A total of 39 cases were identified. The mean age was 61 years, and the cohort was predominantly male (23\/39; 59%). Tumors averaged 4.2\u00a0cm and most commonly arose on the extremities (32\/39; 82%). The majority (38\/39; 97%) were diagnosed at an early pathologic stage (pT1 or pT2). Histopathologically, most tumors were well-circumscribed and were assigned a F\u00e9d\u00e9ration Nationale des Centers de Lutte Contre le Cancer grade of either 1 or 2 (24\/39; 62%). The majority (22\/39; 56%) appeared to arise in association with a blood vessel. Of the 36 cases with accessible clinical data and follow-up (mean 34\u00a0mo, range 0 to 94\u00a0mo), 12 (33%) were noted to have metastasized, with the lung representing the most common anatomic location. One case recurred locally. Six of 36 patients (17%) died from the disease at an average of 47 months after diagnosis (range 16 to 94\u00a0mo). Metastasis or death from disease was significantly associated with the F\u00e9d\u00e9ration Nationale des Centers de Lutte Contre le Cancer grade (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.0015), the presence of necrosis (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.032), tumor size (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.049), and AJCC tumor stage (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.036). These data demonstrate that subcutaneous LMS are more aggressive than dermal-based tumors and have a prognosis akin to that of deep-seated LMS.<\/jats:p>","DOI":"10.1097\/pas.0000000000002126","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T09:00:28Z","timestamp":1695200428000},"page":"1417-1424","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Subcutaneous Leiomyosarcoma"],"prefix":"10.1097","volume":"47","author":[{"given":"Scott C.","family":"Bresler","sequence":"first","affiliation":[{"name":"Department of Pathology"},{"name":"Department of Dermatology"},{"name":"Rogel Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailey L.","family":"Gosnell","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina V.","family":"Angeles","sequence":"additional","affiliation":[{"name":"Department of Dermatology"},{"name":"Rogel Cancer Center"},{"name":"Department of Surgery, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shira","family":"Ronen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Billings","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pathology"},{"name":"Department of Dermatology"},{"name":"Cutaneous Pathology, WCP Laboratories, Inc., Maryland Heights, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,9,19]]},"reference":[{"key":"R1-20250608","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 \u201cleiomyosarcoma\u201d","volume":"35","author":"Kraft","year":"2011","journal-title":"Am J Surg Pathol"},{"key":"R2-20250608","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/j.1600-0560.1996.tb01435.x","article-title":"Intradermal and subcutaneous leiomyosarcoma: a clinicopathological and immunohistochemical study of 41 cases","volume":"23","author":"Jensen","year":"1996","journal-title":"J Cutan Pathol"},{"key":"R3-20250608","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":"R4-20250608","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":"R5-20250608","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/00000478-200201000-00002","article-title":"Leiomyosarcoma of somatic soft tissues: a tumor of vascular origin with multivariate analysis of outcome in 42 cases","volume":"26","author":"Farshid","year":"2002","journal-title":"Am J Surg Pathol"},{"key":"R6-20250608","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1002\/cncr.22395","article-title":"Clinical course of nonvisceral soft tissue leiomyosarcoma in 225 patients from the scandinavian sarcoma group","volume":"109","author":"Svarvar","year":"2007","journal-title":"Cancer"},{"key":"R7-20250608","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1002\/1097-0142(19920701)70:1<114::AID-CNCR2820700119>3.0.CO;2-U","article-title":"Soft tissue leiomyosarcoma. 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