Primary Cutaneous Leiomyosarcoma of the Face: A Rare Tumor that Is Difficult to Diagnose

Leiomyosarcoma is a rare malignant tumour of the lower limbs. Its differential histological diagnosis is difficult and is made in the presence of young scar tissue, leimyoma, dermatofibroma, melanoma, rabdomyosarcoma, sarcomatoid carcinoma, fibroxantoma, Darrier Ferrand dermatofibrosarcoma and myofibroblastic tumours. Treatment is essentially surgical, with margins of 3 to 5 centimetres. We report two observations of tumours localised to the face, including one case of a known leiomyosarcoma and another case initially diagnosed as a leiomyosarcoma which turned out to be a cellular myofibroma with no sign of malignancy after several readings. The aim of this work is to review the literature on this pathology while highlighting the diagnostic and therapeutic difficulties. Conclusion: A rare smooth muscle tumour with a high risk of local recurrence in the event of incomplete treatment, leiomyosarcoma in its dermal component is preferentially located in the head and neck. Its treatment is exclusively surgical and highly mutilating.