Intraosseous Primary Leiomyosarcoma of the Mandible: A Rare Case Report Primary Leiomyosarcoma of the Mandible
Journal of Dental School,
Vol. 38 No. 1 (2020),
22 February 2021
,
Page 37-40
https://doi.org/10.22037/jds.v38i1.31667
Abstract
Objectives Spindle-shaped lesions, which include a wide range of reactive lesions from malignant to very invasive, are among the most challenging head and neck pathologies. Herein, we report a case of leiomyosarcoma (LMS) of the mandible for which, immunohistochemistry was performed to find out whether it was a primary or a metastatic tumor.
Case This case report presents a 23-year-old female with a 3-month history of pain and mild swelling in the anterior mandible. Panoramic radiography and cone-beam computed tomography revealed an osteodestructive lesion in the mandible. The tumor was composed of interlacing fascicles of spindle-like cells with pleomorphism, hyperchromatism, and atypical mitotic figures. Immunohistochemical (IHC) staining revealed that the tumor cells were positive for vimentin, smooth muscle actin (SMA), desmin, and P53 and had negative reactivity for estrogen receptor (ER) and S100. The patient underwent hemi-mandibulectomy with immediate reconstruction via a microvascular fibula flap. The patient died 15 months after surgery due to metastasis to the right pleura.
Conclusion Primary LMS of the jaws is rare and can be confirmed by IHC staining
- Leiomyosarcoma
- Mandible
- Immunohistochemistry
How to Cite
References
Ruka W, Rutkowski P, Krzakowski M, Grzesiakowska U, Ptaszyński K, Jeziorski A, et al. Soft tissue sarcoma-diagnosis and treatment. Onkol Prak Klin. 2009;5(5):198-210.
Lo Muzio L, 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(6):519-24.
Amarapala H, Tilakaratne WM. Leiomyosarcoma of the oral cavity: report of seven cases and review of literature. Oral Oncol Extra 2006;42(1):14-7.
Mendonça EF, Martins da Silva C, Meneghini AJ, Silva GB, Filho JA, Batista AC. Low-grade gingival leiomyosarcoma in a child. J Dent Child (Chic) 2008;75(3):301-5.
Choi YS, Almansoori AA, Jung TY, Lee JI, Kim SM, Lee JH. Leiomyosarcoma of the jaws: case series. J Korean Assoc Oral Maxillofac Surg. 2020 46(4):275-81.
Wertheimer-Hatch L, Hatch GF 3rd, HatchB S KF, Davis GB, Blanchard DK, Foster RS Jr, et al. Tumors of the oral cavity and pharynx. World J Surg 2000;24(4): 395-400.
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 Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 80(3):310-9.
Kuruvilla A, Wenig BM, Humphrey DM, Heffner DK. Leiomyosarcoma of the sinonasal tract. A clinicopathologic study of nine cases. Arch Otolaryngol Head Neck Surg 1990;116(11):1278-86.
Schenberg ME, Slootweg PJ, Koole R. Leiomyosarcomas of the oral cavity. Report of four cases and review of the literature. J Craniomaxillofac Surg 1993;21(8):342-7.
Lewandowski B, Brodowski R, Pakla P, Stopyra W, Gawron I. Leiomyosarcoma in the mandible: A rare case report. Medicine (Baltimore) 2016;95(27):e4011.
Nikitakis NG, Lopes MA, Bailey JS, Blanchaert RH Jr, 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(2):201-8.
Kang BC, Jang DD, Lee SK. Oral leiomyosarcoma in a woodchuck (Marmota monax). J Vet Med Sci 2005;67(3):353-5.
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.
Lloria-Benet M, Bagán JV, Lloria de Miguel E, Borja-Morant A, Alonso S. Oral leiomyoma: a case report. Med Oral 2003;8(3):215-9.
Lack EE, Graham CW, Azumi N, Bitterman P, Rusnock EJ, O'Brien W, et al. Primary leiomyosarcoma of adrenal gland. Case report with immunohistochemical and ultrastructural study. Am J Surg Pathol 1991;15(9):899-905.
Zhang Q, Kanis MJ, Ubago J, Liu D, Scholtens DM, Strohl AE, et al. The selected biomarker analysis in 5 types of uterin smooth muscle tumors.Hum Pathol2018;76:17-27.
Rege IC, Costa NL, Batista AC, da Silva CM, Meneghini AJ, Mendonça EF. High-grade primary leiomyosarcoma in the mandible: diagnosis and treatment. Head Neck 2013;35(2):E44-8.
- Abstract Viewed: 266 times
- PDF Downloaded: 71 times