Uterine Leiomyosarcoma Metastatic to the Scalp

Leiomyosarcoma is an uncommon neoplasm. It occurs more frequently in the uterus, retroperitoneal space, stomach and large vessels. Metastatic leiomyosarcomas to the skin, in general, are extremely rare. Herein, we describe a patient with leiomyosarcomas of uterus who developed multiple cutaneous metastatic leiomyosarcomas on the scalp over the duration of one year. The diagnosis was confirmed by histopathological and immunohistochemical studies, which showed the tumor positively stained for desmin and smooth muscle actin, while negatively stained for cytokeratin S-100 and CD117 (c-kit ). Distant cutaneous metastases from sarcoma usually occur as a late event and carry a poor prognosis. The course in our patient is somewhat unusual, and she is still alive now, which is about 21 months after the occurrence of skin metastasis. (Dermatol Sinica 22 : 69-73, 2004)