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Experimental Generation of Carcinoma-Associated Fibroblasts CAFs from Human Mammary Fibroblasts
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Leiomyosarcoma With Dedifferentiation Mimicking a Benign Neoplasm.

Megan Hoang1, Fatima N Mirza2, Annie R Wang3

  • 1Warren Alpert Medical School of Brown University, Providence, RI.

The American Journal of Dermatopathology
|February 19, 2026
PubMed
Summary

A rare superficial leiomyosarcoma presented atypically in a young woman as a mobile nodule. Prompt diagnosis via excisional biopsy is crucial for this aggressive soft tissue sarcoma.

Keywords:
benign neoplasm mimicrycutaneous leiomyosarcomadedifferentiationlipomaslow-growing subcutaneous nodule

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Area of Science:

  • Oncology
  • Dermatopathology
  • Soft Tissue Sarcomas

Background:

  • Superficial leiomyosarcoma is a rare soft tissue sarcoma, typically affecting adults over 50 with firm, painful nodules.
  • Cutaneous dedifferentiated leiomyosarcoma is exceptionally rare, with only two prior reported cases, both presenting differently.

Purpose of the Study:

  • To report a unique case of superficial leiomyosarcoma with dedifferentiation in an unusual demographic and location.
  • To highlight the diagnostic challenges posed by atypical presentations of soft tissue sarcomas.

Main Methods:

  • Histopathologic evaluation of an excisional biopsy specimen.
  • Immunohistochemical staining for smooth muscle actin and desmin.
  • Clinical correlation and review of existing literature.

Main Results:

  • An intermediate-grade leiomyosarcoma with focal dedifferentiation was identified, showing abrupt transition to a high-grade undifferentiated sarcoma.
  • Immunohistochemistry revealed loss of smooth muscle actin and desmin in the dedifferentiated area.
  • The patient achieved clear margins after wide local excision with no evidence of metastasis.

Conclusions:

  • This case underscores the importance of considering malignancy in persistent subcutaneous nodules, even with atypical presentations.
  • Early recognition and surgical intervention are vital due to the aggressive nature and metastatic potential of dedifferentiated leiomyosarcoma.
  • This report contributes to the limited understanding of cutaneous dedifferentiated leiomyosarcoma, particularly its varied clinical manifestations.