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Yancoskie AE, Trochesset DA, Merer D, Fantasia JE, Kumar AM. Oral leiomyomatous hamartoma: presentation of 3 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:e1-e7. [PMID: 38619102 DOI: 10.1016/j.oooo.2023.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/05/2023] [Accepted: 07/26/2023] [Indexed: 04/16/2024]
Abstract
Oral leiomyomatous hamartoma (OLH) is a rare lesion, with only 40 cases reported in the literature. It typically presents early in life as a nodule on the anterior maxillary alveolar tissues or the tongue. Its growth potential is limited, with few cases reaching dimensions >2.0 cm, and its microscopic composition includes an intact surface mucosa with an underlying fibrovascular stroma possessing an unencapsulated proliferation of smooth muscle fascicles. Excision is considered the definitive treatment. Here we describe the clinical, microscopic, histochemical, and immunohistochemical features and management of 3 cases of OLH and review the literature. The findings we present here can assist in performing differential diagnosis, particularly in discriminating between OLH and similar yet non-hamartomatous processes and in selecting appropriate management.
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Affiliation(s)
- Aaron E Yancoskie
- Touro College of Dental Medicine at New York Medical College, Hawthorne, NY, USA; New York Medical College, Valhalla, NY, USA.
| | - Denise A Trochesset
- Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | | | - John E Fantasia
- Zucker Hofstra/Northwell School of Medicine LIJMC, New Hyde Park, NY, USA
| | - Arthi M Kumar
- Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
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2
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Sánchez-Romero C, Bonan PRF, Pires FR, Oliveira Silva-Junior G, Delgado Azañero W, Almeida OPD, Perez DEDC. Leiomyomatous Hamartomas of the Oral Cavity: Clinicopathological and Immunohistochemical Features of 4 Cases and Literature Review. Int J Surg Pathol 2019; 27:624-630. [DOI: 10.1177/1066896919843337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To present 4 new cases of oral leiomyomatous hamartomas (OLH), describing its clinical, microscopical, and immunohistochemical features, and a literature review. Methods. The OLH cases were retrieved from the files of 2 Brazilian and 1 Peruvian oral pathology services. Clinical data were obtained from the pathology reports. Microscopical features were reviewed, and immunohistochemical reactions were performed. A review of the English-language literature about OLH was done. Results. The sample was composed of 3 females (4-, 10-, and 15-year-old) and 1 male (3-year-old). Three cases affected the dorsum of the tongue and one the incisive papilla, and all presented sessile or pedunculated smooth nodules. Microscopically, the lesions were composed of varying-size fascicles of smooth muscle fibers in a fibrous connective tissue background. Immunohistochemistry revealed positivity of the smooth muscle bundles for myogenic markers. The English-language literature review revealed 38 OLH cases reported, most were congenital or diagnosed up to 5 years old. The main locations were tongue and anterior maxilla. Conclusions. Although OLH is a rare lesion, it must be considered in the differential diagnosis of midline tongue or maxillary masses in newborns, infants, and youngsters.
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3
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Freitas da Silva DM, Fernandes IA, Wu A, Neville BW. Oral Leiomyomatous Hamartoma of the Anterior Maxillary Gingiva. Clin Adv Periodontics 2016; 6:190-194. [PMID: 31535479 DOI: 10.1902/cap.2016.160022] [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] [Received: 03/15/2016] [Accepted: 04/03/2016] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Oral leiomyomatous hamartoma (OLH) is a rare developmental tumor-like anomaly of the oral cavity. CASE PRESENTATION This report documents a 4-year-old female who was diagnosed with an OLH of the palatal gingiva between the maxillary central incisors. This lesion was treated successfully by local surgical excision. CONCLUSION Because many of the reported cases of this lesion have developed on the anterior maxillary gingiva, it is important for the periodontist to be aware of this entity.
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Affiliation(s)
| | - Ighor A Fernandes
- Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Alice Wu
- Private practice, Fayetteville, NC
| | - Brad W Neville
- Division of Oral Pathology, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC
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4
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ALQahtani D, Qannam A. Oral leiomyomatous hamartoma of the median maxillary gingiva: a case report and review of the literature. Int J Surg Pathol 2013; 21:413-6. [PMID: 23349471 DOI: 10.1177/1066896912471852] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Oral leiomyomatous hamartoma (OLH) is a rare lesion seen in the oral cavity. It mainly presents on the median maxilla and tongue. In the literature in English, there are only 10 reported cases of OLH of the median maxilla. Most of the cases were found in patients of Japanese and Latin American origin. We report a case of OLH in an 18-month-old boy of Middle Eastern ancestry. The lesion presented as a pedunculated, light pink, soft swelling that was located on the labial gingiva of tooth number 21. Microscopically, it showed proliferative smooth-muscle fascicles dispersed in loose fibrous stroma and multiple small vessels. The lesional cells looked mature and elongated and were deeply eosinophilic spindle cells with basophilic, central "cigar-shaped" nuclei. The diagnosis of OLH was supported by positive immunohistochemical reactivity of smooth-muscle actin and desmin. To our knowledge, this is the first reported case of OLH in a Middle Eastern patient.
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5
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Woo SB. Diseases of the oral mucosa. MCKEE'S PATHOLOGY OF THE SKIN 2012:362-436. [DOI: 10.1016/b978-1-4160-5649-2.00011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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6
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Woo SB. Developmental and Congenital Conditions. ORAL PATHOLOGY 2012:7-27. [DOI: 10.1016/b978-1-4377-2226-0.00002-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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7
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Zhang M, Matsuo K, Yamashita Y, Takahashi T. Leiomyomatous hamartoma of the midline maxillary gingival presenting as a congenital epulis: a case report with an immunohistochemical study. Int J Oral Maxillofac Surg 2011; 40:1322-6. [PMID: 21696920 DOI: 10.1016/j.ijom.2011.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Revised: 04/04/2011] [Accepted: 05/10/2011] [Indexed: 11/24/2022]
Abstract
An otherwise-healthy 2-year-old Japanese female presented with a polyp-like lesion on the palatal surface at the incisive papilla. The appearance of the lesion was similar to that of a congenital epulis. The histological findings showed proliferating mesenchymal components that contained mainly smooth muscle admixed with collagen fibres, nerve fibres, small vessels and mucous salivary glands. The immunohistochemical staining findings for α-smooth-muscle actin, desmin and S-100 protein were all positive. The histological diagnosis was therefore leiomyomatous hamartoma, based on clinical microscopic observations.
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Affiliation(s)
- M Zhang
- Division of Oral Pathology, Department of Biosciences, Kyushu Dental College, Kokurakitaku, Kitakyushu, Japan.
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8
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Coombs PR, Gilbertson T, Teoh M. Prenatal sonographic diagnosis of a congenital oral fibrovascular hamartoma. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 37:736-738. [PMID: 21165981 DOI: 10.1002/uog.8913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/13/2010] [Indexed: 05/30/2023]
Abstract
We report the diagnosis of a congenital oral fibrovascular hamartoma with two- and three-dimensional ultrasound. The distinctive sonographic features including the fibrovascular stalk and a single vascular pedicle are described. Prenatal magnetic resonance imaging and postnatal computed tomography confirmed the ultrasound findings. Despite concerns about impaired swallowing, the prenatal and perinatal courses were straightforward. The lesion was removed soon after birth. Histopathology of the removed lesion provided the definitive diagnosis of a fibrovascular hamartoma and reported a cellular composition that differentiates it from similar lesions. To our knowledge, such a lesion has not been reported pre- or postnatally and provides an alternative differential diagnosis for a fetus presenting with a mouth mass.
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Affiliation(s)
- P R Coombs
- Diagnostic Imaging, Monash Medical Centre, Southern Health, Melbourne, Australia.
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9
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de Faria PR, Batista JD, Duriguetto AF, do Nascimento Souza KC, Candelori I, Cardoso SV, Loyola AM. Giant Leiomyomatous Hamartoma of the Tongue. J Oral Maxillofac Surg 2008; 66:1476-80. [DOI: 10.1016/j.joms.2007.06.679] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Revised: 04/19/2007] [Accepted: 06/07/2007] [Indexed: 11/28/2022]
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10
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Nava-Villalba M, Ocampo-Acosta F, Seamanduras-Pacheco A, Aldape-Barrios BC. Leiomyomatous hamartoma: report of two cases and review of the literature. ACTA ACUST UNITED AC 2008; 105:e39-45. [DOI: 10.1016/j.tripleo.2007.12.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Revised: 12/12/2007] [Accepted: 12/13/2007] [Indexed: 11/16/2022]
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Abstract
A small polypoid lesion was removed from the incisive papilla region of a healthy female aged 8 years. It was composed of non-cycling smooth muscle fibres that were immunoreactive for various muscle antigens, surrounded by basement membrane containing collagen IV, arranged as bundles and mixed with CD34(+) interstitial cells, mast cells, dendrocytes and nerves. The lesion could be attributed to dysgenesis affecting media of vessels emerging from the incisive foramen. Intra-oral smooth muscle hamartomas tend to favour regions featuring complex developmental events.
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Affiliation(s)
- H Zaitoun
- Paediatric Dentistry, Department and School of Dental Studies, The University of Liverpool, Liverpool, UK
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12
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Iida S, Kishino M, Senoo H, Okura M, Morisaki I, Kogo M. Multiple leiomyomatous hamartoma in the oral cavity. J Oral Pathol Med 2007; 36:241-4. [PMID: 17391303 DOI: 10.1111/j.1600-0714.2007.00518.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Leiomyomatous hamartoma (LH) is congenital lesion rarely seen in oral cavity. In English literature, all reported cases appeared as solitary lesion in alveolar ridge or the tongue, and there have never been a report showing a case of multiple occurrence of this lesion. A quite rare case of multiple LH occurred in a 2-year-old Japanese boy is presented. A polypoid lesion was presented at incisive papilla and two isolated lesions in the tongue dorsum, one appeared as a polypoid mass in the posterior dorsum and other as a small spindle-shaped agger in the anterior dorsum. All of them were histologically diagnosed as LH.
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Affiliation(s)
- Seiji Iida
- The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan.
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13
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Takeyama J, Miyota H, Nagasaka H. Hamartoma on the hard palate associated with corpus callosum agenesis, microphthalmia, and skin malformation. J Oral Maxillofac Surg 2007; 65:553-6. [PMID: 17307607 DOI: 10.1016/j.joms.2005.11.069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Revised: 04/06/2005] [Accepted: 11/14/2005] [Indexed: 11/19/2022]
Affiliation(s)
- Junji Takeyama
- Department of Pathology, Miyagi Children's Hospital, Sendai, Japan.
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14
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Kujan O, Clark S, Sloan P. Leiomyomatous hamartoma presenting as a congenital epulis. Br J Oral Maxillofac Surg 2005; 45:228-30. [PMID: 16162370 DOI: 10.1016/j.bjoms.2005.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2004] [Accepted: 07/29/2005] [Indexed: 10/25/2022]
Abstract
An otherwise-healthy 11-month-old white girl presented with a polyp-like lesion on the anteromedial part of the maxillary alveolar ridge. It looked like a congenital epulis, but histological examination showed fascicles of smooth muscle cells dispersed in collagenous stroma with a few peripheral nerve bundles that were intermingled with smooth muscle fibres. The muscle cells stained strongly for desmin and alpha-smooth-muscle actin. However, S-100 was found only in peripheral nerve bundles. It was therefore a leiomyomatous hamartoma.
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Affiliation(s)
- Omar Kujan
- Unit of Oral Pathology, School of Dentistry, University of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK
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