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Zisis V, Poulopoulos A, Fotopoulos I, Lillis T, Dabarakis N, Anagnostou E, Andreadis D. A Differential Clinical Diagnostic Challenge of a Recurrent, Oral Fibrosarcoma Resembling a Periapical Lesion of Endodontic Origin. Cureus 2023; 15:e49836. [PMID: 38164303 PMCID: PMC10758238 DOI: 10.7759/cureus.49836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 01/03/2024] Open
Abstract
A fibrosarcoma is a neoplastic growth originating from malignant, fibroblast-like mesenchymal cells. This malignant tumor shows an increased tendency for expansion and recurrence and a propensity to metastasize, especially to the lungs. Despite their rarity, fibrosarcomas have the potential to manifest in any anatomical location. An oncologist referred their patient due to reported mandibular discomfort, ache, and swelling. The biopsy revealed a fibrosarcoma resembling a periapical lesion of endodontic origin. The timely intervention and the collaboration among different but complementary medical and dental specialties ensure that the patient may enjoy a prolonged life expectancy as symptom-free as possible.
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Affiliation(s)
- Vasileios Zisis
- Oral Medicine/Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Athanasios Poulopoulos
- Oral Medicine/Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Ioannis Fotopoulos
- Dentoalveolar Surgery, Implantology and Oral Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Theodoros Lillis
- Dentoalveolar Surgery, Implantology and Oral Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Nikolaos Dabarakis
- Dentoalveolar Surgery, Implantology and Oral Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Eleftherios Anagnostou
- Oral Medicine/ Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Dimitrios Andreadis
- Oral Medicine/Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Lombardi N, Varoni EM, Rabbiosi D, Cucurullo M, Moneghini L, Lodi G. Primary oral leiomyosarcoma of the maxillary bone and sinus: case report and up-to-date review of literature. Braz J Otorhinolaryngol 2022; 88 Suppl 4:S205-S211. [PMID: 34756559 DOI: 10.1016/j.bjorl.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- Niccolò Lombardi
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan, Italy; ASST Santi Paolo e Carlo, Odontostomatology II Unit, Milan, Italy.
| | - Elena M Varoni
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan, Italy; ASST Santi Paolo e Carlo, Odontostomatology II Unit, Milan, Italy
| | - Dimitri Rabbiosi
- ASST Santi Paolo e Carlo, Maxillofacial Surgery Unit, Milan, Italy
| | - Marco Cucurullo
- ASST Santi Paolo e Carlo, Maxillofacial Surgery Unit, Milan, Italy
| | - Laura Moneghini
- ASST Santi Paolo e Carlo, Human Pathology Unit, Milan, Italy
| | - Giovanni Lodi
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan, Italy; ASST Santi Paolo e Carlo, Odontostomatology II Unit, Milan, Italy
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Kaplan I, Raiser V, Shuster A, Shlomi B, Rosenfeld E, Greenberg A, Hirshberg A, Yahalom R, Shnaiderman-Shapiro A, Vered M. Metastatic tumors in oral mucosa and jawbones: Unusual primary origins and unusual oral locations. Acta Histochem 2019; 121:151448. [PMID: 31570205 DOI: 10.1016/j.acthis.2019.151448] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM To perform clinico-pathological characterization of a large series of oral metastases, collected from 3 main medical centers in Israel and compare findings to data on frequency of primary cancer types in the population. MATERIALS Pathology archives were searched for cases of metastatic tumors to the oral soft tissues and jawbones, 1990 - 2016. Metastases to the skin of face or to major salivary glands have been excluded. Demographic data and histopathological features were analyzed. RESULTS Study population included 60 patients, 35 females and 25 males (ratio of 1.4:1). The age range was 17-87 years, mean 67.7 + 14.36 years. Only 3 (5%) patients were under 40 years, the remaining clustered predominantly in the 60-80 year age group. The mean age of females (59 + 13.84) was significantly lower than that of males (67.44 + 14) (p = 0.03). There was an almost equal distribution between the oral soft tissue and the jawbones (48.3% and 51.7%, respectively). The five most common organs from which metastases were distributed to the oral cavity and jawbones combined were kidney (20%), breast (15%), cutaneous (predominately melanoma, 13%), lung (11.7%) and soft tissue-sarcomas (8.3%). For comparison, Israel National Cancer Registry 2013 reported that the most frequent malignancies were breast (25.8%), colorectal cancer (16.3%), lung (12%) and prostate (10%). Malignant melanoma was 6th (5.4%), kidney malignancy was only 9th in frequency (4.2%). Although the gingiva and jawbones were the most frequent locations, some cases presented in unusual locations, (mandibular vestibule, lower lip, posterior dorsal tongue), without any specific clinical feature to suggest metastasis. CONCLUSIONS The most frequent primary origins for oral metastasis do not correspond to the relative frequency of the primary tumors in the population, indicating that metastatic spread is not a random process. Although the majority of metastasis involves the gingiva and jawbones, any other oral mucosal location might be involved. Thus, in adult/older patients, metastasis from a distant site should be included in the differential diagnosis of oral masses at any oral location, whether the existence of a primary tumor is reported or not.
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Ko E. Primary oral leiomyosarcoma: A systematic review and update. J Oral Pathol Med 2019; 48:780-787. [PMID: 30958581 DOI: 10.1111/jop.12858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/26/2019] [Accepted: 04/01/2019] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Eugene Ko
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Zacher M, Heppt MV, Brinker TJ, Hayani KM, Flaig MJ, Berking C. Primary leiomyosarcoma of the skin: a comprehensive review on diagnosis and treatment. Med Oncol 2018; 35:135. [PMID: 30140957 DOI: 10.1007/s12032-018-1196-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/15/2018] [Indexed: 12/19/2022]
Abstract
Sarcomas are a heterogeneous group of mesenchymal tumors which can affect bone and soft tissue. Leiomyosarcoma (LMS) is a rare subtype localized to the skin or subcutaneous tissue. Due to the heterogeneity of sarcomas, reviews and guidelines with an in-depth focus specifically on primary LMS of the skin are sparse. This article is intended to provide an up to date and systematic overview on diagnosis, treatment, and surveillance of this rare entity to provide a framework for decision making and management for dermato-oncologists. We discuss novel treatment options for advanced disease such as targeted therapy with kinase inhibitors and immune checkpoint blockade which may improve the prognosis even in advanced stages of LMS.
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Affiliation(s)
- Martina Zacher
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Markus V Heppt
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Titus J Brinker
- Department of Dermatology, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany.,Department of Translational Oncology, German Cancer Research Center, National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Kinan M Hayani
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Michael J Flaig
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Carola Berking
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany.
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Akhtar K, Hasan SA, Sherwani RK, Ahmad M. Fibrosarcoma of the Gingiva: An Unusual Presentation. Oman Med J 2016; 31:312-4. [PMID: 27403246 DOI: 10.5001/omj.2016.60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Fibrosarcoma is a malignant tumor of the fibroblasts, which is liable to recur and metastasize, most frequently in the lungs. Although fibrosarcomas are rare, they can occur anywhere in the body. The most common sites are in the retroperitoneum, thigh, knee, and distal extremities. It is very uncommon in the head and neck region and comprises only about 1% of all the malignancies in humans. Almost 23% are seen in the oral cavity. The prognosis for fibrosarcomas is poor with a five-year survival rate of 20-35%. The common modality of treatment is radical surgery. We report a rare presentation of gingival fibrosarcoma in a young female, who presented with a painless lump.
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Affiliation(s)
- Kafil Akhtar
- The Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
| | - Syed Abrar Hasan
- ENT Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
| | - Rana K Sherwani
- The Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
| | - Murad Ahmad
- The Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
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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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Taghipour Zahir S, Sharahjin NS. Leiomyosarcoma of the maxilla in a 24-year-old man who initially presented with odontalgia, and suffered from tumour mismanagement. BMJ Case Rep 2013; 2013:bcr-2013-200933. [PMID: 24311413 DOI: 10.1136/bcr-2013-200933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Leiomyosarcoma is an uncommon malignant soft tissue tumour originating from smooth muscle cells. It generally occurs in the female genital tract, especially in the uterus, gastrointestinal tract, retroperitoneum and rarely in the head and neck. Here we report a case of leiomyosarcoma in a 24-year-old man with a 6-month history of toothache and extraction of three right upper molar teeth, that was complicated by fistula tract formation and facial swelling. Imaging studies demonstrated tumoural lesions involving the right maxillary sinus, nasal cavity, hard palate and orbit. The histopathological and immunohistochemical studies confirmed that it was leiomyosarcoma.
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Affiliation(s)
- Shokouh Taghipour Zahir
- Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Islamic Republic of Iran
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Farronato G, Porro A, Galbiati G, Giannini L, Moffa M, Maspero C. Riassorbimento radicolare: Revisione della letteratura. DENTAL CADMOS 2013. [DOI: 10.1016/s0011-8524(13)70040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ulcerated pedunculated mass of the maxillary gingiva. ACTA ACUST UNITED AC 2009; 108:313-7. [PMID: 19589701 DOI: 10.1016/j.tripleo.2009.05.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 04/16/2009] [Accepted: 05/25/2009] [Indexed: 01/30/2023]
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Boy SC, Van Heerden WFP, Steenkamp G. Diagnosis and treatment of primary intraoral leiomyosarcomas in four dogs. Vet Rec 2005; 156:510-3. [PMID: 15833968 DOI: 10.1136/vr.156.16.510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This paper describes the clinical and pathological features, diagnosis and management of primary intraoral leiomyosarcomas in the oral cavity of four dogs; they involved the gingivae of the rostral maxilla and mandible, the mucosa of the upper lip and the soft palate. Their features are compared with the those of leiomyosarcomas commonly encountered in the gastrointestinal tract of dogs. Two of the dogs responded well to surgical treatment; one died after its airways were obstructed by a large palatal tumour; and the fourth was lost to follow-up after its owners declined treatment.
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Affiliation(s)
- S C Boy
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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