Oral leiomyosarcoma: review of the literature and report of two cases with assessment of the prognostic and diagnostic significance of immunohistochemical and molecular markers

Nikitakis, Nikolaos G.; Lopes, Márcio Ajudarte; Bailey, Jonathan; Blanchaert, Remy H.; Ord, Robert A.; Sauk, John J.

doi:10.1016/s1368-8375(01)00047-1

Cited by 57 publications

(63 citation statements)

References 32 publications

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“…Presence of fewer than two mitoses in x10 magnification indicates good prognosis. Molecular markers like PCNA, bcl-2, CDK-4, P53, MDM 2 indicate malignancy [21].…”

Section: Discussionmentioning

confidence: 99%

Leiomyoma of hard palate: A rare case report

Reddy¹,

Prasad²,

Krishna³

et al. 2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Case Report: A 14 years old boy presented to our department with a chief complaint of slow-growing mass since six months duration in the left hard palate. Based on the history, clinical, radiological and histopathological findings the mass was diagnosed as leiomyoma of hard palate. Immunohistochemistry was carried out for a more precise confirmation of the tumor, which showed positivity for SMA and vimentin. The mass was treated by extraction of the involved teeth followed by surgical excision of the tumor. No recurrence was noted during four month follow-up. Conclusion: Oral leiomyomas are very rare, with low recurrence rates. These benign lesions respond well to surgical excision of tumor mass. In this paper, we present a case of leiomyoma of hard palate in a 14 years old boy, along with a brief note on review of literature on leiomyoma.

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“…Presence of fewer than two mitoses in x10 magnification indicates good prognosis. Molecular markers like PCNA, bcl-2, CDK-4, P53, MDM 2 indicate malignancy [21].…”

Section: Discussionmentioning

confidence: 99%

Leiomyoma of hard palate: A rare case report

Reddy¹,

Prasad²,

Krishna³

et al. 2017

IJCRI

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“…Leiomyosarcomas (LMS), theirs malignant counterpart, comprise 7% of head and neck sarcomas [2]. Primary LMSs rarely occur in the oral and maxillofacial region, probably due to paucity of smooth muscle tissue in the area [1,3]. Source of smooth muscle in the oral cavity may be the arterial tunica media, lingual duct, circumvallate papillae and pluripotential mesenchymal cells [1].…”

Section: Introductionmentioning

confidence: 99%

“…According to a 2007 study, the sites affected in the oral cavity, in decreasing frequency, are the maxilla and mandible, tongue, buccal mucosa, soft palate, upper lip, and floor of the mouth [10]. Jaw bones have been the most prevalent location for this tumor, accounting for 45% to 68% of the reported cases [3,5,11,12], with the second more frequent site being the tongue [9,11]. The least affected sites were the gingiva and upper lip [5].…”

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confidence: 99%

“…The least affected sites were the gingiva and upper lip [5]. The majority of patients present without nodal and /or distant metastases [13].The prognosis of LMS in the oral and maxillofacial region is usually poor with a high percentage of recurrence and metastasis [3,14]. The reported 5 year survival rate for the primary disease ranges from 50 to 60% [9,10,13].…”

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confidence: 99%

“…Masson's trichrome staining and immuno histochemical evaluation for muscle antigens are helpful in diagnosis separating leiomyosarcoma from other sarcomas [1,5,18]. Positive reactions for desmin, vimentin, smooth-mus cle actin and h-caldesmon have been demonstrated in this neoplasm [5].The diagnosis is most often made on light microscopy and confirmed by immunohistochemistry [3,5,11,12]. Management protocols are lacking due to the rarity of oral lesions.…”

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confidence: 99%

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Primary Leiomyosarcoma of the Mandibular Gingiva

Zanakis¹

2016

Glob J Cancer Ther

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SummaryPrimary oral leiomyosarcomas are exceptionally rare lesions often associated with poor prognosis. We report a case of leiomyosarcoma arising in the anterior mandibular gingiva, which is a non-prevalent site of occurrence. Clinically, the tumor was far from being firm and solid as it is usually described in the literature. Light microscopy failed to confirm the true nature of the lesion on the biopsy specimen.were free but the under surface of the lesion was infiltrating the bone. A complete workup followed, consisting of CT scans (face, neck, chest), upper and lower abdomen ultra sound and a skeletal scanning. The investigation proved negative for lesions elsewhere in the body. Consequently, the patient underwent a wider excision and a peripheral mandibulectomy, preserving the continuity of the mandible, since a partial mandibulectomy was denied by the patient. A split thickness skin graft was used to cover the inner surface of the lower lip and the anterior floor of the mouth. The post-operative period was uneventful. The histopathology report indicated both free soft (confirming the previous report) and hard tissue margins. The surgical ablation was followed by radiotherapy in another institution and according to their files the patient received 66 gray (Gy) locally in 33 fragments and 52 Gy in the neck in 26 fragments. Six months postoperatively the patient presented with osteoradionecrosis of the jaw, a pathologic fracture of the mandibular symphysis and edema of the lower lip. At that time, biopsies were taken, with negative results. The patient refused admission as well as the scheduled hyperbaric oxygen therapy; simultaneously, underwent a complete CT workout (brain, face, neck, chest, upper and lower abdomen), that was negative for pathology (LMS or colon adenocarcinoma). Two months later the IntroductionBenign smooth muscle tumors, or leiomyomas, are common, well-circumscribed neoplasms that can arise from smooth muscle cells anywhere in the body, but are encountered most commonly in the uterus [1]. Leiomyosarcomas (LMS), theirs malignant counterpart, comprise 7% of head and neck sarcomas [2]. Primary LMSs rarely occur in the oral and maxillofacial region, probably due to paucity of smooth muscle tissue in the area [1,3]. Source of smooth muscle in the oral cavity may be the arterial tunica media, lingual duct, circumvallate papillae and pluripotential mesenchymal cells [1]. We present a case of oral LMS which exhibits an uncommon clinical appearance in a non-prevalent site and which also presents difficulties in the histopathologic diagnosis of the incisional biopsy. Case ReportAn 81-year-old Caucasian female attended the outpatient department, complaining of a painless mass in the region of her anterior mandibular ridge, causing difficulty in mastication. On examination the mass measured 4x3x3cm, was bluish-red in color, soft and friable in consistency and boss elated in appearance. The lesion was broad-based and firmly attached to the underlying tissues. The patient was partially edentulous an...

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