Leimyosarcoma of the buccal mucosa and review of literature

Abstract

Leiomyosarcoma (LMS) is an uncommon malignant spindle cell tumor of the head and neck region. The occurrence is particularly rare in the buccal mucosa of the oral cavity. It is a rapidly growing tumor with aggressive behavior and poor prognosis. Method: This article presents a rare case of primary leimyosarcoma of the buccal mucosa in a 35 year old female and retrospective analysis of primary oral LMS published in the English literature since past 20 years is done. Diagnosis was confirmed by immunohistochemistry profile showing positivity for vimentin, smooth muscle actin (SMA), high proliferative index displayed by Ki-67, focal positivity for pan-CK and negativity for S-100. Conclusion: Based on the presence of malignant spindle cells showing positivity for vimentin and SMA, a diagnosis of leiomyosarcoma was made.

Primary Leiomyosarcoma of the Buccal Mucosa: Report of a Case and Review of the Literature

“…The differential diagnosis of malignant spindle cell tumors in the head and neck includes spindle cell carcinoma and melanoma; sarcomas to be distinguished include malignant nerve sheath tumor and rhabdomyosarcoma [14]. Due to overlap in histologic features, head and neck sarcomas [24] 35 F Buccal mucosa 1.0 × 1.0 n/r n/a n/a Suarez-Alen et al (2015) [25] 66 F Buccal mucosa 2.0 × 1.0 n/r Surgery 52-ANED Present case (2017) 87 M Buccal mucosa NR n/a n/a n/a may be misdiagnosed or misclassified by the pathologist; one review of head and neck soft tissue sarcomas revealed a change in diagnosis by the pathologist in 33-48% of the cases [10]. Given these difficulties, Dry et al pointed out that some of the previously reported cases that did not perform immunohistochemical studies, may in fact not be of myogenic origin [6].…”