Primary Liposarcoma in Oral and Maxillofacial Region:

A case of liposarcoma with osteolysis of the maxilla as the first symptom and review of the literature

Liposarcomas are extremely rare in the oral cavity and mainly observed in the buccal mucosa, tongue, floor of the mouth, gingiva, and lips, while those occurring in the jaws have not been reported so far. Clinically, the initial presentation of liposarcoma is usually a painless soft tissue mass. The aim of this study was to report a case of liposarcoma with osteolysis of the maxilla as the first symptom, and review the relevant literature to summarize its clinical features, imaging features, pathological features and treatment methods.

Massive low-grade myxoid liposarcoma of the floor of the mouth: A case report and review of literature

BACKGROUND

Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign tumor due to its asymptomatic and indolent clinical course. Here, we report a case of massive low-grade myxoid liposarcoma (MLS) of the floor of the mouth.

CASE SUMMARY

A 71-year-old man presented with a huge mass in the left floor of the mouth. A biopsy was performed, and a diagnosis of a myxoid tumor suspicious for low-grade MLS or myxoma was made. Gadolinium-enhanced T1-weighted magnetic resonance imaging showed an intensely enhanced tumor lesion that occupies the left sublingual space and extends to the submandibular space. Submandibular dissection, tumor resection, and reconstruction with a radial forearm flap were performed. The surgical specimen exhibited histologically low-grade MLS. Fused in sarcoma (FUS, also known as TLS) and DNA damage-inducible transcript 3 (DDIT3, also known as CHOP) break-apart was not detected in the fluorescence in situ hybridization analysis. The tumor was completely encapsulated and did not require additional treatment. Furthermore, no recurrence was reported 40 mo after surgery.

CONCLUSION

We experienced an extremely rare, massive, low-grade MLS emerging from the floor of the mouth. Oftentimes, an MLS of the floor of the mouth lacks significant clinical findings and is often misdiagnosed. Although no FUS-DDIT3 fusion gene was detected, a low-grade MLS was ultimately diagnosed based on the histological findings.

Oral liposarcoma in elderly: Case report and literature analysis

RATIONALE

Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign lesion because of its asymptomatic and indolent clinical course. we report a case of atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) of buccal mucosa, provisionally diagnosed as lipoma.

PATIENT CONCERNS

A 97-year-old female was referred to dentistry and oral surgery department with an asymptomatic mass on the right buccal mucosa which had been present for an unknown period of time.

DIAGNOSIS

Magnetic resonance imaging demonstrated a well-circumscribed lesion at the right buccal mucosa, and a lipoma was suspected.

INTERVENTIONS

Surgical removal was performed, and a diagnosis of ALT/WDL was made. She and her family refused additional treatment due to her age.

OUTCOMES

At the 10 months follow-up, the patient remained free of disease.

LESSONS

The indolent clinical course and small size of oral liposarcoma can lead to provisional clinical diagnosis of benign lesion.

Reconstruction of Liposarcoma Resection Defect With a Made-to-Measure Polyethylene Prosthesis Using Three-Dimensional Digital Technology

BACKGROUND

Liposarcoma is considered one of the most frequently occurring tumors of the soft tissues, representing 17% to 30% of all mesenchymal cell tumors. It is less common in the head and neck representing <10% of tumors in this region. The reconstruction of defects derived from resection of these tumors presents a surgical challenge. New three-dimensional digital technologies allow more exact surgery, cause less morbidity, and achieve adequate aesthetic outcomes.

OBJECTIVE

The aim of this article was to describe the complex reconstruction of a defect caused by the resection of a liposarcoma in the temporal region.

METHODS

Three-dimensional technology allowed patient planning and a reconstruction that was as exact as possible. A made-to-measure polymethyl methacrylate prosthesis was used to correct the defect in the zygomatic arch. The temporal fossa was covered with a standard porous polyethylene prosthesis.

CONCLUSIONS

Satisfactory esthetic and functional results were achieved using three-dimensional digital technology for treatment planning and to fabricate a made-to-measure polyethylene prosthesis and surgical guide.

Well-differentiated liposarcoma of the floor of the mouth: Report of a rare case and review of the literature

Liposarcomas are extremely rare in the oral cavity. Less than 100 cases of oral liposarcoma have been reported in the world wide literature, mostly occurring in the buccal mucosa, whereas only <10 cases have been reported in the floor of the mouth. We present a rare case of oral liposarcoma that occurred in the floor of the mouth of a 45-year-old female patient. She had a history of two previous recurrences and underwent surgical excision with 24 months of follow-up. Clinical as well as histopathological features and therapeutic approaches of liposarcomas are discussed here, and a literature review is presented. Intraoral liposarcomas have a high rate of local recurrences but generally favorable prognosis based on the histopathologic subtype, location and clear surgical margins. Conservative surgical therapy without adjuvant chemoradiotherapy is recommended, due to the rarity of distant metastasis.