Primary oral leiomyosarcoma: a clinico-pathologic study and analysis of prognostic factors

Ethunandan, Madan; Stokes, Christopher; Higgins, Bernard; Spedding, Anne V.; Way, Carol; Brennan, Peter A.

doi:10.1016/j.ijom.2006.12.015

Cited by 40 publications

(74 citation statements)

References 42 publications

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“…There are two parameters that seem to be the most important, the mitotic index and the extent of tumor necrosis. Histologic grading is particularly useful as an indication of the probability of distant metastasis and overall survival, but is of poor value for predicting local recurrence which is mainly related to the quality of surgical margins [10]. The two most widely used classification systems are the NCI (United States National Cancer Institute) and the FNCLCC (French Fédération Nationale des Centres de Lutte Contre le Cancer).…”

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confidence: 99%

“…The benefit from chemotherapy or/and adjuvant radiotherapy is that of reducing the recurrence or increasing the survival is considered minor. As a result of this ambiguousness, these modalities are most often considered a palliative measures for inoperable cases [11,15,21], even though some authors' reports beneficial effects [10,13,15]. …”

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confidence: 99%

“…The reported 5 year survival rate for the primary disease ranges from 50 to 60% [9,10,13]. A feature that seems to be related to decreased survival is bony involvement.…”

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confidence: 99%

“…The treatment of choice, is complete surgical resection with or without neck dissection depending on the status of the cervical lymph nodes. Tumor free margins are a prerequisite in order to control local recurrences [10,15]. The benefit from chemotherapy or/and adjuvant radiotherapy is that of reducing the recurrence or increasing the survival is considered minor.…”

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confidence: 99%

“…The ages of the patients ranged from 7 to 91 with a mean age of 44 [5]. 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].…”

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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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confidence: 99%

“…The reported 5 year survival rate for the primary disease ranges from 50 to 60% [9,10,13]. A feature that seems to be related to decreased survival is bony involvement.…”

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confidence: 99%

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confidence: 99%

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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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High‐grade primary leiomyosarcoma in the mandible: Diagnosis and treatment

et al. 2011

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Leiomyosarcomas of the oral cavity: report of a radiation-associated and a metastatic case

Azevedo

Pires

Gouvêa

et al. 2011

Oral Maxillofac Surg

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Post-radiotherapy sarcomas of the oral cavity and oral metastasis from soft tissue sarcomas are very uncommon, but based on patient's clinical history, they should be considered by oral health care providers in order to allow an early diagnosis and proper and timely management. Finally, to the best of our knowledge, this seems to be the first reported case of tongue leiomyosarcoma arising in a previously irradiated field.

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Primary oral leiomyosarcoma: a clinico-pathologic study and analysis of prognostic factors

Cited by 40 publications

References 42 publications

Primary Leiomyosarcoma of the Mandibular Gingiva

Primary Leiomyosarcoma of the Mandibular Gingiva

High‐grade primary leiomyosarcoma in the mandible: Diagnosis and treatment

Leiomyosarcomas of the oral cavity: report of a radiation-associated and a metastatic case

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