Gingival Leiomyosarcoma in a Young Woman: Case report and literature review

Abstract

Leiomyosarcoma (LMS) is a rare mesenchymal malignancy, of which 3-10% of cases occur in the head and neck region. We report a 22-year-old woman who was referred to the University Hospital of Siena, Italy, in 2016 with an ostensibly benign asymptomatic lump on the mandibular gingiva. The lesion grew rapidly, causing otalgia in the right ear. An excisional biopsy was performed and primary LMS was diagnosed histologically. Subsequently, the patient underwent radical re-excision of the perilesional mucosa, a partial bone resection and the extraction of four teeth. No recurrences or metastases were detectable at a 20-month follow-up. This report discusses the differential diagnosis of LMS with regards to other benign and malignant lesions and reviews the recent literature on primary and secondary oral LMS. Due to its innocuous clinical features-including its asymptomatic nature and presentation at a young age-this aggressive malignancy can go undetected; therefore, an early histopathological diagnosis is crucial.

Paediatric head and neck malignant neoplasms: A brazilian retrospective study

“…The etiopathogenesis of leiomysarcoma is uncertain due to its aggressive growth and dissemination pattern, but some studies have pointed to an association with trauma, hormone stimulation, previous cancer treatment with ionizing radiation, some virus (e.g. Epstein-Barr virus infections) and metastasize of a leiomysarcoma from other primary region ( 26 , 27 ).…”

“…The diagnosis is established by an incisional biopsy, followed by lesion excision with extended margin resection and anatomopathological analyses, including immunohistochemistry. The surgery can be combined with adjuvant radiotherapy or/and chemotherapy, and follow-up appointments ( 26 , 27 ).…”

Blastic plasmacytoid dendritic cell neoplasm: a rare case of gingival lesion with leukaemic presentation

“…For this reason, the histopathological analysis has been critical to exclude other benign lesions such as fibromas, neurofibromas, schwannomas, peripheral giant cell granulomas or malignant lesions as, gingival leiomyosarcoma, myofibroblastic sarcomas, melanomas, rhabdomyosarcomas, lymphoma and spindle cell myoepithelial carcinomas. 9 Historically, the tumour was variably thought to arise from either monocytes, T cells or NK cells giving rise to terms such as CD4+/CD56+ acute monoblastic leukaemia, primary cutaneous CD4+/CD56+ haematodermic tumour and blastic NK cell lymphoma. In the literature, there are several cases of NK/T cell lymphoma which debut with destructive ulcer of the palate/uvulae.…”