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Kenea TT, Kebede BA, Gozjuze FM, Kiros H, Wilde F. Primary Leiomyosarcoma of the Mandibular Alveolar Mucosa of a 12-Year-Old Child from Ethiopia: A Case Report. Craniomaxillofac Trauma Reconstr 2017; 10:56-59. [PMID: 28210409 DOI: 10.1055/s-0036-1582459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 12/06/2015] [Indexed: 10/21/2022] Open
Abstract
Leiomyosarcomas (LMSs) are rare malignant mesenchymal tumors which show smooth-muscle differentiation. Most LMSs involving the oral tissues primarily affect the maxillary sinus, the maxillary or mandibular bone. We present a case of LMS of the mandibular alveolar mucosa, arising in a 12-year-old male child from Ethiopia. A malignant spindle cell-like neoplasm was diagnosed on clinical and radiographic findings as well as on incisional biopsy. The tumor was resected with wide margins. The following histopathologic examination with additional immunohistochemical studies secured the diagnosis LMS. Microscopically, the spindle-shaped tumor cells were arranged in an interlacing fascicular pattern and contained oval to elongated, blunt-ended (cigar-shaped) nuclei. The immunohistochemical examination showed immunoreactive tumor cells for vimentin, actin, desmin, and H-caldesmon, which is pathognomonic for LMS. Immunohistochemical studies are mandatory to differentiate the LMS from other similar spindle cell neoplastic lesions. Radical resection with safety margins and a lifelong periodic follow-up has to be recommended.
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Affiliation(s)
- Tewodros Tefera Kenea
- Department of Cranio-Maxillofacial and Oral Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - Betel Abebe Kebede
- Department of Pediatrics and Child Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Hagos Kiros
- Department of Pathology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Frank Wilde
- Department of Oral and Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital Ulm University, Ulm, Germany
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Sandhu SV, Sodhi SPS, Rai S, Bansal H. Primary leiomyosarcoma of the maxilla: An investigative loom-report of a challenging case and review of literature. J Oral Maxillofac Pathol 2015; 18:453-9. [PMID: 25949006 PMCID: PMC4409196 DOI: 10.4103/0973-029x.151350] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 12/31/2014] [Indexed: 11/17/2022] Open
Abstract
Leiomyosarcoma (LMS) is a malignant neoplasm composed of cells showing distinct smooth muscle features. Majority of the tumors are located in the retroperitoneum, including the pelvis and the uterus but are rare in the oral and pharyngeal region. Intraorally, they are present as painless, lobulated, fixed masses of the submucosal tissues in middle-aged or older individuals. Lesions are usually slow growing and are less than 2 cm in diameter at the time of diagnosis. Here we report the clinico-pathological findings of a case of primary LMS of the maxilla in 63-year-old male patient with an emphasis on the judicious use of ancillary diagnostic modalities to arrive at a definitive diagnosis.
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Affiliation(s)
- Simarpreet Virk Sandhu
- Department of Oral and Maxillofacial Pathology, Genesis Institute of Dental Sciences and Research, Ferozepur, India
| | - S P S Sodhi
- Department of Oral and Maxillofacial Surgery, Dashmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Sachin Rai
- Department of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Himanta Bansal
- Department of Oral and Maxillofacial Pathology, Genesis Institute of Dental Sciences and Research, Ferozepur, India
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3
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Rege ICC, Costa NL, Batista AC, da Silva CM, Meneghini AJ, Mendonça EF. High-grade primary leiomyosarcoma in the mandible: Diagnosis and treatment. Head Neck 2011; 35:E44-8. [DOI: 10.1002/hed.21853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 05/04/2011] [Accepted: 05/20/2011] [Indexed: 11/08/2022] Open
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4
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Crossman T, Ward P, Herold J. Leiomyosarcoma of the tongue: a case report. Br J Oral Maxillofac Surg 2008; 46:e69-70. [DOI: 10.1016/j.bjoms.2008.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2008] [Indexed: 11/29/2022]
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5
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Yadav R, Bharathan S. Leiomyosarcoma of the buccal mucosa: a case report with immunohistochemistry findings. J Oral Sci 2008; 50:215-8. [DOI: 10.2334/josnusd.50.215] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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6
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Primary oral leiomyosarcoma: a clinico-pathologic study and analysis of prognostic factors. Int J Oral Maxillofac Surg 2007; 36:409-16. [PMID: 17395428 DOI: 10.1016/j.ijom.2006.12.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2006] [Revised: 11/04/2006] [Accepted: 12/27/2006] [Indexed: 11/21/2022]
Abstract
This clinico-pathologic study of primary oral leiomyosarcomas and analysis of potential prognostic factors involved a literature review of 64 cases and a report of four cases treated in the authors' unit. The demographic details, clinical presentation, diagnosis, treatment and outcome were documented for the whole group and clinico-pathologic variables analysed to detect potential prognostic factors. The most common presentation was that of a painless mass, with peak incidence in the 6th decade and a slight male predeliction (M:F=1.3:1). The maxilla was the most frequently involved site, followed by the mandible and tongue. Surgical excision was most commonly employed with radiotherapy and chemotherapy being reserved for recurrent and metastatic tumours. Local recurrence (34%) and metastasis (35%) were not uncommon and occurred most frequently to the lungs and regional lymph nodes (15%). Age, sex, size and mitotic index were not statistically related to recurrence or metastasis. Site (P=0.0125) was a predictor of metastasis. Metastasis (P=0.010) and lesions involving the maxilla and mandible (P=0.019) were associated with decreased survival. The estimated 5 year survival was 55% for the whole group and 43% and 19% for patients with bony involvement and metastasis respectively.
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7
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Vilos GA, Rapidis AD, Lagogiannis GD, Apostolidis C. Leiomyosarcomas of the oral tissues: clinicopathologic analysis of 50 cases. J Oral Maxillofac Surg 2005; 63:1461-77. [PMID: 16182914 DOI: 10.1016/j.joms.2005.06.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2003] [Accepted: 06/06/2005] [Indexed: 11/28/2022]
Abstract
PURPOSE Primary oral leiomyosarcomas are rare tumors. Information regarding the biological behavior, prognosis, and appropriate management of this neoplasm is lacking in the literature. The purpose of this report was to summarize the data of isolated case reports of primary oral leiomyosarcoma that have been published in the English literature during the past 25 years. The cases of 4 additional new patients who have been treated in our department during the past 10 years are also presented. PATIENTS AND METHODS The data for 46 patients obtained from 32 individual articles retrieved from the English literature were added to our 4 cases and produced a total number of 50 cases of primary leiomyosarcomas of the oral tissues. Patients were analyzed according to demographic data, anatomic location, type of treatment, and survival. RESULTS Primary oral leiomyosarcoma may affect any age with peaks of occurrence in the third, sixth, and seventh decades of life. There is no gender predilection. Female patients presented the higher incidence in the third decade, whereas males had an even age distribution. The tumor arises in approximately 70% of the cases in the maxillary and mandibular bones. Radical surgery was the treatment of choice. Radiotherapy and chemotherapy when applied in recurrent tumors had little effect. The most adverse prognostic factor was the positive surgical margins. The 5-year survival was 62% (62.9% for females and 52.6% for males, P > .1968). CONCLUSIONS Cases of oral leiomyosarcoma appear to be associated with major neurovascular structures of the facial skeleton, as evidenced from the imaging studies of our 4 patients. Primary oral leiomyosarcoma is a rare tumor that should be managed with aggressive surgical resection in order to safeguard curability. Histopathologic diagnosis is greatly facilitated with positive immunohistochemical staining for smooth muscle antigenic markers.
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Affiliation(s)
- Georgios A Vilos
- Maxillofacial Surgical Oncology, Greek Anticancer Institute, St Savvas Hospital, 171 Alexandras Avenue, Athens 115-22, Greece
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MacGillivray KC, Graham TD, Parente EJ. Multicentric leiomyosarcoma in a young male horse. J Am Vet Med Assoc 2004; 223:1017-21, 986. [PMID: 14552492 DOI: 10.2460/javma.2003.223.1017] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 2-year-old male Thoroughbred was evaluated for multiple firm, raised nodules of the maxilla and mandible that had been present since 6 months of age. The horse was evaluated as a yearling with a final histologic diagnosis of fibrosarcoma. As a 2-year-old, the colt made a loud upper airway sound and was agitated after strenuous exercise. Results of upper airway endoscopy indicated severe narrowing of the nasal passages and pharynx with normal resting function. Radiography revealed multiple circular bony lesions in the mandible, maxilla, multiple long bones, and cervical vertebrae. Biopsy specimens of the left mandible and right facial bone were obtained. A diagnosis of leiomyosarcoma with extensive metastatic bone formation was made on the basis of histologic features and the immunohistochemical staining properties of the biopsy specimens. Because of the diffuse distribution of the lesions, prognosis was guarded; 4 years after diagnosis, the horse had not pursued an athletic career.
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Affiliation(s)
- Katherine Cole MacGillivray
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 W Street Rd, Kennett Square, PA 19348, USA
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Fasanmade A, Barrett A, Newman L, Hyde N. Primary Leiomyosarcoma of the Oral Cavity: A Case Report and Review of the Literature. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2002. [DOI: 10.1177/229255030201000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Leiomyosarcoma is a malignant tumour of mesenchymal origin that is uncommon in the head and neck, and particularly uncommon in the oral cavity. This article presents a case of primary leiomyosarcoma affecting the mucosal lining of the cheek in a 35-year-old woman. The need for wide excision is emphasized, and because of the high frequency of regional lymph node metastasis, an ipsilateral neck dissection is advocated, followed by adjuvant radiotherapy for residual microscopic disease.
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Affiliation(s)
- A Fasanmade
- Guy's, King's and St Thomas' School of Medicine and Dentistry
| | - Aw Barrett
- Oral and Maxillofacial Pathology Unit, Eastman Dental Institute, University College London
| | - L Newman
- Maxillofacial Unit, University College London Hospitals NHS Trust, London, United Kingdom
| | - Nc Hyde
- Maxillofacial Unit, University College London Hospitals NHS Trust, London, United Kingdom
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10
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Lo Muzio L, Favia G, Farronato G, Piattelli A, Maiorano E. Primary gingival leiomyosarcoma. A clinicopathological study of 1 case with prolonged survival. J Clin Periodontol 2002; 29:182-7. [PMID: 11895547 DOI: 10.1034/j.1600-051x.2002.290214.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Leiomyosarcoma is a relatively uncommon mesenchymal tumor that exhibits smooth-muscle differentiation. Only 3 to 10% of leiomyosarcomas arise in the head and neck, the nose and paranasal sinuses, skin and subcutaneous tissue and cervical esophagus being the most common localizations. Most leiomyosarcomas involving the oral tissues primarily affect the maxillary sinus, the maxillary or mandibular bone. A review of the English-language literature since 1908 revealed 30 reported cases of primary leiomyosarcoma of the oral mucosa and soft tissues. MATERIAL AND METHODS We report on a case of gingival leiomyosarcoma, arising in a 31-year-old female and involving the upper alveolar mucosa. Following the diagnosis of malignant neoplasm on frozen sections and an en-block resection, the tumour was formalin-fixed and paraffin embedded for histological and immunohistochemical examination. RESULTS Microscopically, the tumor was composed of interlacing fascicles of spindle-shaped cells with elongated, blunt-ended nuclei and eosinophilic cytoplasm, containing PAS-positive granules. Mitoses, both typical and atypical, and scattered necrotic foci were present. Consistent desmin, muscle specific and alpha-smooth muscle-specific, and vimentin immunoreactivity was demonstrated in the tumor cells. The patient is alive and free of disease at a 7-year follow-up. CONCLUSIONS Intra-oral leiomyosarcomas are exceptionally rare. Accurate diagnosis and treatment is largely based on the careful search of clinical signs indicative of malignancy (e.g., neoplastic bone destruction, wide invasion of adjacent tissues) and intra-operative (frozen sections) examination of the lesion. Though the case reported herein showed an attenuated clinical behavior, prolonged follow-up is mandatory in view of possible tumor relapse.
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Affiliation(s)
- Lorenzo Lo Muzio
- Department of Dental Sciences, University of Ancona, Ancona, Italy.
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11
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Nikitakis NG, Lopes MA, Bailey JS, Blanchaert RH, Ord RA, Sauk JJ. Oral leiomyosarcoma: review of the literature and report of two cases with assessment of the prognostic and diagnostic significance of immunohistochemical and molecular markers. Oral Oncol 2002; 38:201-8. [PMID: 11854069 DOI: 10.1016/s1368-8375(01)00047-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Leiomyosarcoma of the oral cavity is a very rare tumor that is associated with aggressive clinical behavior and low survival. In this paper, we report two new cases of leiomyosarcoma affecting the mandibular gingiva and mandible of a 35-year-old male and the mandible of a 51-year-old female. Given the difficulty in the histopathologic discrimination between benign and malignant smooth muscle tumors and the absence of reliable histologic parameters for prognostication of leiomyosarcomas, we evaluated the diagnostic and prognostic value of various immunohistochemical and molecular markers. By means of immunohistochemistry and quantitative real-time PCR analysis, we detected protein expression of PCNA, bcl-2, CDK4, p53 and MDM2 in both our cases and MDM2 amplification in our second case. The literature, pertinent to oral leiomyosarcoma and to molecular analysis of smooth muscle tumors, is reviewed.
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Affiliation(s)
- Nikolaos G Nikitakis
- Department of Oral and Maxillofacial Pathology, Dental School, University of Maryland, Baltimore 666 W. Baltimore Street, Room 4-C-02, Baltimore, MD 21201-1586, USA.
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12
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Favia G, Mignogna MD, Piattelli A, Maiorano E. Primary intraoral leiomyosarcoma of the tongue: an immunohistochemical study and review of the literature. Oral Oncol 2000; 36:519-24. [PMID: 11036245 DOI: 10.1016/s1368-8375(00)00044-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Leiomyosarcoma is a relatively uncommon mesenchymal tumor that exhibits smooth-muscle differentiation. We report a new case of leiomyosarcoma involving the tongue of a 67-year-old male. Histologically, the tumor was composed of variably oriented fascicles of spindle-shaped cells with 'cigar-shaped' nuclei and eosinophilic cytoplasm, containing occasional PAS-positive granules. Atypical mitotic figures and necrotic foci were frequently detected. Consistent desmin, alpha-smooth muscle-specific and sarcomeric actin, and vimentin immunoreactivity was demonstrated in the tumor cells, whereas cytokeratins, CD 30, CD 31, CD 34, CD 45, CD 68, EMA, GFAP, HMB 45 and S-100 protein were negative. The patient underwent wide surgical excision of the tumor and is alive and disease-free at a 5-year follow-up. This report emphasizes the difficulties in the differential diagnosis of these uncommon tumors in an intra-oral location.
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13
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Shimoyama T, Horie N, Ide F. Epithelioid hemangioma of the tongue mimicking a malignancy. J Oral Maxillofac Surg 2000; 58:1317-9. [PMID: 11078148 DOI: 10.1053/joms.2000.16640] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- T Shimoyama
- Department of Oral Surgery, Saitama Medical Center, Saitama Medical School, Japan
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14
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Dry SM, Jorgensen JL, Fletcher CD. Leiomyosarcomas of the oral cavity: an unusual topographic subset easily mistaken for nonmesenchymal tumours. Histopathology 2000; 36:210-20. [PMID: 10692022 DOI: 10.1046/j.1365-2559.2000.00814.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS Oral leiomyosarcoma is rare and poorly documented. We aimed to characterize these lesions clinicopathologically in order to facilitate their distinction from other spindle cell neoplasms in the oral cavity. METHODS AND RESULTS Ten cases of oral leiomyosarcoma were retrieved and studied histologically and immunohistochemically. Clinical data were obtained from referring pathologists and prior literature concerning 46 comparable cases was reviewed. Nine out of 10 cases occurred in adults; 50% arose in the jaws and four showed bone involvement. Histological appearances were similar to leiomyosarcomas elsewhere. In addition to myogenic markers, two cases were also keratin-positive. Four patients developed local recurrence or metastatic disease and three died of tumour (median follow-up 37 months). CONCLUSIONS Leiomyosarcoma is under-recognized in the mouth, often being mistaken for a spindle-celled epithelial neoplasm. Aside from an unusual but infrequent tendency to spread to lymph nodes and a location-specific differential diagnosis, its clinicopathological features are comparable to leiomyosarcomas at other locations.
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Affiliation(s)
- S M Dry
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
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15
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Goldschmidt PR, Goldschmidt JD, Lieblich SE, Eisenberg E. Leiomyosarcoma presenting as a mandibular gingival swelling: a case report. J Periodontol 1999; 70:84-9. [PMID: 10052775 DOI: 10.1902/jop.1999.70.1.84] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report a case of primary low-grade leiomyosarcoma of the mandible in an otherwise healthy young woman. The neoplasm presented as a painful, pericoronal gingival swelling that mimicked an acute periodontal infection. It was managed accordingly, with curettage, debridement, and antibiotics. When the lesion failed to respond to this treatment approach, a biopsy was performed. Microscopy revealed a malignant mesenchymal neoplasm which, on immunohistochemistry analysis, demonstrated reactivity for smooth muscle actin (SMA) and vimentin. This established the diagnosis of leiomyosarcoma; subsequently, an en bloc resection of mandibular bone and overlying soft tissue was performed. Close follow-up for over 10 years has revealed no evidence of recurrent or metastatic disease. Since the patient was taking oral contraceptives prior to the onset of the lesion, a possible link between estrogen and smooth muscle tumors is considered.
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Affiliation(s)
- P R Goldschmidt
- School of Dental Medicine, University of Connecticut, Farmington, USA
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16
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Savastano G, Palombini L, Muscariello V, Erra S. Leiomyosarcoma of the maxilla: a case report. J Oral Maxillofac Surg 1998; 56:1101-3. [PMID: 9734775 DOI: 10.1016/s0278-2391(98)90265-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- G Savastano
- Department of Maxillo-Facial Surgery, Faculty of Medicine, University of Naples, Napoli, Italy
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17
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Mesquita RA, Migliari DA, de Sousa SO, Alves MR. Leiomyosarcoma of the buccal mucosa: a case report. J Oral Maxillofac Surg 1998; 56:504-7. [PMID: 9541354 DOI: 10.1016/s0278-2391(98)90723-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- R A Mesquita
- Department of Oral Pathology, School of Dentistry, University of Minas Gerais, Belo Horizonte, Brazil
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18
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Laccourreye O, Cauchois R, Laccourreye L, Maurice D, Carnot F, Brasnu D. Primary leiomyosarcoma of the mandible. Am J Otolaryngol 1996; 17:415-9. [PMID: 8944303 DOI: 10.1016/s0196-0709(96)90077-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- O Laccourreye
- Department of Otorhinolaryngology-Head and Neck Surgery and Pathology, Hôspital Laënnec, Université Paris V, France
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Izumi K, Maeda T, Cheng J, Saku T. Primary leiomyosarcoma of the maxilla with regional lymph node metastasis. Report of a case and review of the literature. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1995; 80:310-9. [PMID: 7489275 DOI: 10.1016/s1079-2104(05)80389-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A rare case of oral leiomyosarcoma diagnosed with the aid of immunohistochemical and electron microscopic examinations together with a review of the literature are reported. The patient was a 70-year-old Japanese man. The primary tumor involved the maxillary gingiva and bone and metastasized to the cervical lymph nodes. On histologic examination the tumor showed invasive growth into the maxillary bone. It was composed of interlacing fascicles of spindle-shaped cells with eosinophilic cytoplasm and elongated, blunt-ended nuclei. The tumor formed extensive metastatic foci in the cervical lymph nodes. On immunohistochemical examination most of the tumor cells were positive for desmin, smooth muscle-specific actin, and myosin. The ultrastructural characteristics of the tumor cells were abundant microfilaments, pinocytotic vesicles, and basement membrane formation. The findings were indicative of a tumor demonstrating myogenic differentiation. A review of the literature during the past 50 years disclosed a total of 60 oral leiomyosarcomas, including our case.
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Affiliation(s)
- K Izumi
- First Department of Oral and Maxillofacial Surgery, Niigata University School of Dentistry, Japan
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