Oral leiomyosarcoma: the importance of early diagnosis

Suárez-Alén, Fátima; Rey, Eva Otero; Peñamaría-Mallón, Manuel; García‐García, Abel; Carrión, Andrés Blanco

doi:10.1111/ger.12126

Cited by 9 publications

(22 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The differential diagnosis of malignant spindle cell tumors in the head and neck includes spindle cell carcinoma and melanoma; sarcomas to be distinguished include malignant nerve sheath tumor and rhabdomyosarcoma [14]. Due to overlap in histologic features, head and neck sarcomas [24] 35 F Buccal mucosa 1.0 × 1.0 n/r n/a n/a Suarez-Alen et al (2015) [25] 66 F Buccal mucosa 2.0 × 1.0 n/r Surgery 52-ANED Present case (2017) 87 M Buccal mucosa NR n/a n/a n/a may be misdiagnosed or misclassified by the pathologist; one review of head and neck soft tissue sarcomas revealed a change in diagnosis by the pathologist in 33-48% of the cases [10]. Given these difficulties, Dry et al pointed out that some of the previously reported cases that did not perform immunohistochemical studies, may in fact not be of myogenic origin [6].…”

Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma of the Buccal Mucosa: Report of a Case and Review of the Literature

McHugh

2018

Head and Neck Pathol

View full text Add to dashboard Cite

This clinicopathologic study of primary oral leiomyosarcoma of the buccal mucosa involves a literature review of 15 cases with the addition of our report of a case. The demographic details, tumor size, treatment and outcome are documented for all the cases. In addition, this review examines the histologic features of leiomyosarcoma while noting that differentiation from other spindle cell tumors can be challenging, underscoring the necessity of an immunohistochemical work up for an accurate diagnosis. The unpredictability of the clinical behavior of these aggressive tumors requires, at the very least, wide local surgical excision and prolonged follow up.

show abstract

Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma of the Buccal Mucosa: Report of a Case and Review of the Literature

McHugh

2018

Head and Neck Pathol

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Besides early diagnosis, the prognosis of oral LMS patients depends on the tumour grade, size, site and treatment. [20][21][22] Currently, there are no standard criteria for therapy, although the complete excision of the tumour with wide surgical margins is recommended. 7,23,24 The five-year survival rate among patients with primary oral LMS is 55%, with bone involvement and metastasis significantly associated with poorer prognosis.…”

Section: Discussionmentioning

confidence: 99%

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

Viviano

Miracco

Lorenzini

et al. 2018

Sultan Qaboos Univ Med J

View full text Add to dashboard Cite

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.

show abstract

“…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].…”

mentioning

confidence: 99%

“…The clinical manifestation of oral LMS is usually that of a distinct, painless, circumscribed mass, which is firmly adhered to deeper planes, lacking specific symptoms that allow for its differentiation from other similar lesions [8,9]. There is no clear sex predilection, but it is noticeable that in the third and seventh decade, there were 50% more female than male patients.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Primary Leiomyosarcoma of the Mandibular Gingiva

Zanakis¹

2016

Glob J Cancer Ther

View full text Add to dashboard Cite

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...

show abstract

Oral leiomyosarcoma: the importance of early diagnosis

Abstract: Early diagnosis and treatment play a key role in a better prognosis.

Cited by 9 publications

References 11 publications

Primary Leiomyosarcoma of the Buccal Mucosa: Report of a Case and Review of the Literature

Primary Leiomyosarcoma of the Buccal Mucosa: Report of a Case and Review of the Literature

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

Primary Leiomyosarcoma of the Mandibular Gingiva

Contact Info

Product

Resources

About