Cutaneous Leiomyoma: A Clinical Study of 152 Patients

Dermatology. 2022;238(3):587-593. doi: 10.1159/000518542. Epub 2021 Sep 23.

Abstract

Background: Cutaneous leiomyoma (CL) is a benign smooth muscle tumour included in painful skin tumours. Multiple CLs are cutaneous markers of hereditary leiomyomatosis and renal cell cancer (HLRCC).

Objectives: To retrospectively review our series of patients with CLs to analyse their clinical features and the association with HLRCC.

Methods: Cases coded as CL in the database of the pathology department between 2004 and 2019 were included in the study. Medical records were retrospectively reviewed to obtain the following data: age, sex, location, number of lesions, diameter, evolution time at diagnosis, suspected clinical diagnosis, tenderness, status of resection margins, development of recurrence, follow-up time, and association with HLRCC.

Results: 152 patients had CLs, 89 women and 63 men, mean age 56.26, SD 16.030 years. Subtypes were piloleiomyoma in 62 patients, angioleiomyoma in 80, and genital leiomyoma in 10. All of our 11 patients with multiple lesions corresponded to piloleiomyomas, and HLRCC was confirmed in 8 of them (73%). Patients with HLRCC were younger than patients with piloleiomyomas without HLRCC (34.88 vs. 56.17 years, p = 0.009). Vascular and genital leiomyomyomas were solitary and were not associated with HLRCC.

Conclusion: In patients with multiple piloleiomyomas HLRCC must be ruled out as it is confirmed in a high proportion of cases. The probability of fumarate hydratase mutation is greater in multiple piloleiomyomas involving both the trunk and upper extremities in the same patient.

Keywords: Cutaneous leiomyoma; Hereditary leiomyomatosis; Piloleiomyoma; Renal cell cancer.

MeSH terms

  • Female
  • Fumarate Hydratase / genetics
  • Humans
  • Kidney Neoplasms* / genetics
  • Leiomyomatosis* / diagnosis
  • Male
  • Middle Aged
  • Neoplastic Syndromes, Hereditary*
  • Retrospective Studies
  • Skin Neoplasms* / pathology
  • Uterine Neoplasms

Substances

  • Fumarate Hydratase

Supplementary concepts

  • Hereditary leiomyomatosis and renal cell cancer