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Cutaneous leiomyoma in a child: A case report
Nursel Dilek1, Derya Yüksel, Ibrahim Sehitoğlu
1Departments of Dermatology, Recep Tayyip Erdoğan University Medical Faculty Hospital, Rize 53000, Turkey.
Insights
Pilar leiomyoma, a rare skin tumor in children, presents as multiple masses. Early diagnosis through clinical assessment and biopsy is crucial for effective treatment of this benign smooth muscle neoplasm.
Area of Science:
- Dermatology
- Pediatric Oncology
- Pathology
Background:
- Cutaneous leiomyomas, rare benign tumors originating from arrector pili muscles, typically affect adults.
- While uncommon in children, leiomyomas can manifest as cutaneous or mucosal masses.
Purpose of the Study:
- To report a rare case of pilar leiomyoma in a pediatric patient.
- To emphasize the importance of considering leiomyoma in the differential diagnosis of pediatric skin lesions.
Main Methods:
- Clinical presentation of multiple firm, red-brown back masses in a 10-year-old female.
- Diagnostic punch biopsy with histopathological examination revealing spindle cells.
- Immunohistochemical analysis confirming smooth muscle actin (SMA) positivity.
Main Results:
- Histopathology showed spindle cells with eosinophilic cytoplasm.
- Immunohistochemistry confirmed strong positivity for SMA, indicative of smooth muscle origin.
- The patient was diagnosed with pilar leiomyoma.
Conclusions:
- Pilar leiomyoma, though rare, should be considered in the differential diagnosis of pediatric cutaneous and mucosal masses.
- Prompt clinical evaluation and appropriate diagnostic workup are essential for accurate diagnosis and management.
- Surgical excision is the recommended treatment for symptomatic or cosmetically concerning lesions.
Abstract:
Leiomyoma is a benign tumour commonly encountered in the genitourinary and gastrointestinal organs in adults. Cutaneous leiomyomas are rare benign tumors arising from the arrector pili muscle of hair follicles. Cutaneous leiomyomas are more likely to occur in adults than in children. We describe a case of a 10-year-old female who presented with multiple, firm, red-brown masses on the back. A punch biopsy was performed. Under high-power examination, spindle cells with an eosinophilic cytoplasm were observed and immunohistochemical studies were performed; the cells stained strongly positive for smooth muscle actin (SMA). The patient was subsequently diagnosed with pilar leiomyoma and referred to a plastic surgeon for surgical treatment. Although cutaneous leiomyoma is a rare disorder, we identified a case of pilar leiomyoma in a young female. A careful clinical assessment led to the correct diagnosis and therapy in the present case. We propose that leiomyoma ought to be considered in the differential diagnosis of any cutaneous or mucosal mass in children.
