Leiomyosarcoma of the sinonasal tract is an extremely rare neoplasm, with identical histological appearance and immunoprofile to the soft tissue counterpart [91]. If the tumour is limited to the nasal cavity the prognosis is good, and according to Kuruvilla et al. [144], sinonasal leiomyosarcoma can be regarded as a locally aggressive neoplasm with limited metastatic potential that should be treated by surgery alone. Distinction from sinona-sal leiomyoma is based on mitotic activity and cellular atypia.

Fig. 2.18. Sinonasal malignant epithelioid schwannoma: marked S-100 protein positivity in a large cell malignant neoplasm, mimicking amelanotic melanoma

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