Cutaneous leiomyosarcoma: a retrospective review of 45 cases.

We propose that for dermal LMS, a clinical margin of 5-10 mm (depending on size of lesion) at the initial excision or at scar re-excision following involved/close histological peripheral and/or deep margins (i.e. < 1 mm) is undertaken. For subcutaneous LMS, a clinical margin of 15-20 mm (depending on size of lesion) to achieve a peripheral histological clearance of 10 mm and negative deep margin (i.e. > 1 mm) down to periosteum/fascia/muscle according to anatomical site is suggested. If this is not achieved, a re-excision would be recommended. However, prospective studies are needed for optimal guidance.