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Finally, cutaneous metastases from LMS indicate progression of a primary tumor, generally of visceral origin, and are associated with an approximate survival of 16 months from the time of detection.7 Before a definitive diagnosis of a primary LMS of the skin can be established, it is essential to rule out metastasis from an LMS in the deep tissues or organs, particularly if the tumor is subcutaneous

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Carbohydrates in general stimulate the release of insulin, which can help to increase the uptake of amino acids, including L-carnitine, into the muscle cells