LeiomyosarcomaLeiomyosarcoma (LMS) is an uncommon spindle cellSpindle cellneoplasmNeoplasm of smooth muscle origin that may arise in the skin or subcutaneous tissue. LMS displays an infiltrative growth pattern and stains positively with immunohistochemistryImmunohistochemistry for vimentin, desmin, smooth muscle actin, and H-caldesmon. Superficial dermal LMS is distinct from LMS of soft tissue origin which is characterized by a high local recurrence rateRecurrence rates with conventional wide excisionWide excision and potential for metastasis. While the metastatic potential of superficial cutaneousCutaneous tumors is thought to be minimal, local recurrence can occur following conventional excision. Mohs micrographic surgeryMohs micrographic surgery results in lower recurrence ratesRecurrence rates and offers the advantage of tissue sparing.