Recurrent nodule on the nasal columella: a good reason to re-biopsy

Background  A 15‐year‐old Caucasian male presented with 9‐month history of a recurrent nodule on the nasal columella. The previous biopsy was reported as a neurofibroma. Methods  Frozen sections revealed a spindle cell neoplasm. Permanent section immunohistochemistry sections stained positive for vi...

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Bibliographic Details
Published in:International journal of dermatology 2008-07, Vol.47 (7), p.728-731
Main Authors: Vujevich, Justin J., Goldberg, Leonard H., Kimyai-Asadi, Arash, Law, Robert
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Biopsy, Needle
Dermatology
Diagnosis, Differential
Follow-Up Studies
Frozen Sections
Humans
Immunohistochemistry
Leiomyosarcoma - diagnosis
Leiomyosarcoma - pathology
Leiomyosarcoma - surgery
Male
Medical sciences
Mohs Surgery - methods
Nasal Septum - pathology
Nasal Septum - surgery
Neoplasm Recurrence, Local - diagnosis
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - surgery
Neurofibroma - diagnosis
Neurofibroma - pathology
Skin Neoplasms - diagnosis
Skin Neoplasms - pathology
Treatment Outcome
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Summary:Background  A 15‐year‐old Caucasian male presented with 9‐month history of a recurrent nodule on the nasal columella. The previous biopsy was reported as a neurofibroma. Methods  Frozen sections revealed a spindle cell neoplasm. Permanent section immunohistochemistry sections stained positive for vimentin and smooth muscle actin and negative for S100 and CD34, confirming the diagnosis of leiomyosarcoma. Results  The tumor was removed using Mohs micrographic surgery. Radiological work‐up revealed no distant metastasis. There has been no local recurrence to date. Conclusions  Leiomyosarcoma is a difficult diagnosis to make clinically and requires histological confirmation. Re‐biopsy of a “benign” growth may be necessary if clinicopathological correlation does not match with the clinical behavior of the tumor in question. Finally, Mohs micrographic surgery is a useful treatment modality for leiomyosarcomas, particularly those located in cosmetically‐sensitive regions of the body such as the nose.
ISSN:0011-9059
1365-4632
DOI:10.1111/j.1365-4632.2008.03536.x