Intraosseous leiomyosarcoma of the mandible: a case report

Malignant Lesions Mimicking Endodontic Pathoses Lesion: A Systematic Review

INTRODUCTION

Malignant nonendodontic periapical lesions represent a rare diagnosis, in which few case have been reported about this condition. Due to the low occurrence and little exploration of this subject, serious errors of diagnosis are observed in the oral medicine services. In this sense, the purpose of the present review was to integrate the information on the record published on malignant lesions that mimic endodontic pathoses into a comprehensive analysis of their clinical, radiologic, and histopathologic features.

METHODS

An online search was made in March 2020 in the following databases: Pubmed, Web of Science, and Scopus. Eligibility criteria included publications having enough clinical, radiologic, and histopathologic information to confirm the diagnosis. Data were assessed descriptively.

RESULTS

Forty-nine publications from 16 countries comprising 60 cases were included. There is a nearly equal occurrence rate between males and females (male/female ratio is 49.15%/50.84%) with a mean age of 46.56 years. The lesions were more prevalent in the posterior mandibles (40.69%), and, radiographically, they were unilocular radiolucent. Histopathologic analysis showed metastasis (26.67%) as the most prevalent lesion followed by salivary gland malignant disease (25%).

CONCLUSIONS

The present systematic review revealed several histologic types of malignant periapical lesions that could be mimicking endodontic pathoses. Because these lesions usually do not show clinical or radiologic features of malignant alteration, clinicians should consider these hypotheses in their routine.

Primary oral leiomyosarcoma: A systematic review and update

The aim of this systematic review was to address the clinicopathologic inconsistencies noted with primary oral leiomyosarcoma in the literature by amassing the available data published into a comprehensive analysis. Eligibility criteria included publications of cases with dedicated immunohistochemical work-up along with radiographs to evaluate location. Based on these criteria, the systematic review compiled 29 cases. Four primary location sites were identified in the reported cases: soft tissue presentation only, soft tissue with bony involvement, bony involvement only, and bony involvement with a soft tissue component. The majority of primary oral leiomyosarcoma cases reviewed showed a soft tissue predilection, which is in contrast to prior reports of jawbones being the most common site. In addition, there was an improved 5-year survival rate for primary oral leiomyosarcoma limited to the oral cavity and gnathic bones without extension into paranasal sinuses.

Leiomyosarcoma of Mandible: A Diagnostic Dilemma; Case Report and Review of Literature

Leiomyosarcoma and its pleomorphic variant are rare entities in the head and neck region. Since they usually present as slow growing, discrete firm, and non-ulcerated painless mass, they seem to be deceptively benign and are thus misdiagnosed. Histopathological and immunohistochemical studies are the ways of getting a definitive diagnosis. Till date surgery has been the primary treatment but effectiveness of radiotherapy/chemotherapy is still questionable. Here, we describe a case of leiomyosarcoma in mandible along with discussion about the ways of diagnosis, its differentiation with its pleomorphic variant and their managements.

Primary leiomyosarcoma in the floor of mouth: a case report

Leiomyosarcoma (LMS) is a malignant soft tissue tumor that exhibits smooth muscle differentiation, and its occurrence in the oral cavity is exceedingly rare, especially in the floor of mouth. A 54-year-old male was admitted for evaluation of a painless nodular mass in the left floor of mouth with a 3-month history. With the help of computed tomography (CT) and magnetic resonance imaging (MRI) examination, the patient went on a surgery excision, and by pathological and immunohistochemical findings, a diagnoses of LMS was confirmed. Then the patient went on chemotherapy, and six-month follow up showed no recurrence of cancer. The diagnosis of LMS is difficult to be made, and it is usually confirmed by immunohistochemical stains, such as positive for smooth muscle actin (SMA), vimentin, and Ki-67.