Leiomyosarcoma of the jaw: case series

Abstract

Objectives: Leiomyosarcoma is a malignant neoplasm that affects smooth muscle tissue and it is very rare in the field of oral and maxillofcial surgery. The purpose of this study was to obtain information on diagnosis of and treatment methods for leiomyosarcoma by retrospectively reviewing of the cases. Patients and Methods: The study included nine patients who were diagnosed with leiomyosarcoma in the Department of Oral and Maxillofacial Surgery at Seoul National University Dental Hospital. The subjects were analyzed with respect to sex, age, clinical features, primary site of disease, treatment method, recurrence, and metastasis. Results: Particular clinical features included pain, edema, mouth-opening limitations, dysesthesia, and enlarged lymph nodes. All cases except one were surgically treated, and recurrence was found in two cases. Four of nine patients were followed up without recurrence and one patient underwent additional surgery due to recurrence. Conclusion: In our case series, notable symptoms included pain, edema, mouth-opening limitations, and dysesthesia; however, it was difficult to label these as specific symptoms of leiomyosarcoma. Considering the aggressive characteristics of the disease and poor prognosis, surgical treatment is necessary with careful consideration of postoperative radiotherapy and chemotherapy.

Primary oral leiomyosarcoma of the maxillary bone and sinus: case report and up-to-date review of literature

“…3,10 LMS frequently affects the retro-peritoneal region, the uterus and the gastrointestinal tract. 1,11 Oral LMS are extremely rare, accounting for 0.64% of all LMS and for 5.7% of head and neck LMS. 5,11 The jawbones appear the most frequently affected oral sites (70% of cases) followed by tongue, buccal mucosa, soft palate, upper lip and floor of the mouth, 1,5,11,12 although a recent systematic review, which reported published case of intra-oral LMS up to 2017, found that soft tissues were more frequently involved than bone.…”

“…1,11 Oral LMS are extremely rare, accounting for 0.64% of all LMS and for 5.7% of head and neck LMS. 5,11 The jawbones appear the most frequently affected oral sites (70% of cases) followed by tongue, buccal mucosa, soft palate, upper lip and floor of the mouth, 1,5,11,12 although a recent systematic review, which reported published case of intra-oral LMS up to 2017, found that soft tissues were more frequently involved than bone. 3 Oral LMS can occur at any age, commonly in the 5 ---7 th decades, with similar gender incidence rate (M:F, 11:9).…”

“…3 Oral LMS can occur at any age, commonly in the 5 ---7 th decades, with similar gender incidence rate (M:F, 11:9). 3,11 Clinically, it appears as a growing mass, painless and firm, which infiltrate the surrounding tissues with no pathognomonic signs. 1,3 Due to its rarity, oral LMS can be misdiagnosed with other common benign lesions before biopsy.…”

“…1,3 Due to its rarity, oral LMS can be misdiagnosed with other common benign lesions before biopsy. 11 Moreover, due to overlapping histological features between different types of head and neck sarcomas, this lesion could be also misclassified for other more common spindle cell tumors of the oral cavity. 3,5,13 For this reason, histological examination associated with immunohistochemical confirmation is mandatory to obtain a definitive diagnosis of oral LMS.…”

“…3,5,13 For this reason, histological examination associated with immunohistochemical confirmation is mandatory to obtain a definitive diagnosis of oral LMS. 1,3,11,13 Surgical resection with tumour-free margins is widely accepted as the treatment of choice for oral LMS. 1,3,5,11 In cases where the anatomical location of tumor does not allow radical surgical intervention, radiotherapy and administration of neoadjuvant/adjuvant chemotherapy may improve survival time and decrease or delay the recurrence rate.…”