[Subcutaneous leiomyosarcoma metastatic to the eyelid]

Area of Science:

• Oncology
• Dermatology
• Pathology

Background:

• Metastatic eyelid lesions are uncommon, with carcinomas being the most frequent type.
• Leiomyosarcomas, typically originating in the uterus or gastrointestinal tract, are rare soft tissue sarcomas.
• Dermal leiomyosarcomas metastasizing to the eyelid have not been previously documented.

Observation:

• A 28-year-old female presented with a rapidly growing right lower eyelid tumor.
• The patient had a history of excised subcutaneous leiomyosarcoma of the neck, followed by radiotherapy, chemotherapy, and detection of distant metastases.
• Histological examination of the eyelid tumor revealed spindle cells with characteristic features of leiomyosarcoma, confirmed by smooth muscle actin positivity.

Findings:

• This case represents the first documented instance of a subcutaneous leiomyosarcoma metastasizing to the eyelid.
• The patient's history included widespread metastases from the primary leiomyosarcoma prior to the eyelid involvement.
• Histopathology confirmed the eyelid lesion as a metastatic leiomyosarcoma.

Implications:

• This case expands the known metastatic sites for leiomyosarcoma.
• It suggests that clinicians should consider leiomyosarcoma in the differential diagnosis of eyelid tumors, especially in patients with a history of soft tissue sarcoma.
• The findings imply that parenchymal metastases may precede dermal metastases in leiomyosarcoma, influencing surveillance strategies.