Common Spindle Cell Malignant Neoplasms of the Skin: Differential Diagnosis and Review of the Literature

Malignant and borderline-malignant neoplasms of the dermis can pose diagnostic challenges. Because these tumors can share similar clinical and histologic features, including a predominantly spindle cell morphology, the pathologist must be familiar with these entities in order to facilitate accurate diagnosis, as treatment for these tumors may be different. We review several of these lesions with respect to clinical and histologic features: desmoplastic melanoma, spindle cell carcinoma, spindle cell atypical fibroxanthoma, dermatofibrosarcoma protuberans, and cutaneous leiomyosarcoma.