Leiomyosarcoma of the head and neck: a clinicopathological study

Montgomery, Elizabeth; Goldblum, John R.; Fisher, Cyril

doi:10.1046/j.1365-2559.2002.01412.x

Cited by 71 publications

(78 citation statements)

References 46 publications

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“…The other large cohort study of MacCarthy et al [2] included patients with secondary tumors, but the locations were also not matched to secondary tumor type. In addition, ten cases in the literature of LMS arising in patients with a history of RB originated in areas adjacent to the sinonasal cavity (orbit, maxilla) for which it is possible the sinonasal tract was involved by extension but did not appear to be the original or significantly involved site [10,[15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of head and neck LMS are of moderate or high histologic grade, behave aggressively, and show little response to chemotherapy or radiation [19,21].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment generally consists of radical resection, and chemotherapy and radiation therapy have been used with limited success [3]. Tumors confined to the nasal cavity in which complete excision can be achieved have a high rate of survival [19]. However, in many cases of sinonasal LMS complete resection is not possible with negative margins, and in these cases mortality is much higher [19].…”

Section: Discussionmentioning

confidence: 99%

“…Tumors confined to the nasal cavity in which complete excision can be achieved have a high rate of survival [19]. However, in many cases of sinonasal LMS complete resection is not possible with negative margins, and in these cases mortality is much higher [19].…”

Section: Discussionmentioning

confidence: 99%

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Nasal Sinus Leiomyosarcoma in a Patient with History of Non-Hereditary Unilateral Treated Retinoblastoma

Fitzpatrick

Woodworth

Monteiro

et al. 2010

Head and Neck Pathol

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Hereditary patients with a history of treated retinoblastoma (RB) have a greatly increased risk of a broad spectrum of secondary malignancies appearing many years later, with a high incidence in the head and neck region. Leiomyosarcomas (LMS) account for up to 58% of these tumors. LMS in the sinonasal region generally are uncommon and are associated with a locally aggressive course and have a poor prognosis. RB may occur in two forms. The hereditary form is generally bilateral but can present unilaterally with a positive family history and typically exhibits a germline mutation in the RB1 gene on chromosome 13. The non-hereditary form is usually unilateral but can show the same germline mutation in up to 10% of cases. Patients with hereditary RB have been shown to have a significantly higher cumulative risk of developing secondary malignancies than those with the non-hereditary form (28 vs. 1.44% respectively). Most reported cases of sinonasal LMS are in patients with a history of the bilateral hereditary form of treated RB. We report a case of LMS of the nasal sinus area in a 35-yearold African American male with a history of non-hereditary unilateral RB and radiation therapy. To the best of our knowledge, this is the first reported case of sinonasal LMS arising in a patient with a history of non-hereditary unilateral RB. The clinical history, radiology, and pathology are presented along with a brief discussion of the literature.

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Section: Discussionmentioning

confidence: 99%

“…The majority of head and neck LMS are of moderate or high histologic grade, behave aggressively, and show little response to chemotherapy or radiation [19,21].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nasal Sinus Leiomyosarcoma in a Patient with History of Non-Hereditary Unilateral Treated Retinoblastoma

Fitzpatrick

Woodworth

Monteiro

et al. 2010

Head and Neck Pathol

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“…According to a 2007 study, the sites affected in the oral cavity, in decreasing frequency, are the maxilla and mandible, tongue, buccal mucosa, soft palate, upper lip, and floor of the mouth [10]. Jaw bones have been the most prevalent location for this tumor, accounting for 45% to 68% of the reported cases [3,5,11,12], with the second more frequent site being the tongue [9,11]. The least affected sites were the gingiva and upper lip [5].…”

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confidence: 99%

Primary Leiomyosarcoma of the Mandibular Gingiva

Zanakis¹

2016

Glob J Cancer Ther

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SummaryPrimary oral leiomyosarcomas are exceptionally rare lesions often associated with poor prognosis. We report a case of leiomyosarcoma arising in the anterior mandibular gingiva, which is a non-prevalent site of occurrence. Clinically, the tumor was far from being firm and solid as it is usually described in the literature. Light microscopy failed to confirm the true nature of the lesion on the biopsy specimen.were free but the under surface of the lesion was infiltrating the bone. A complete workup followed, consisting of CT scans (face, neck, chest), upper and lower abdomen ultra sound and a skeletal scanning. The investigation proved negative for lesions elsewhere in the body. Consequently, the patient underwent a wider excision and a peripheral mandibulectomy, preserving the continuity of the mandible, since a partial mandibulectomy was denied by the patient. A split thickness skin graft was used to cover the inner surface of the lower lip and the anterior floor of the mouth. The post-operative period was uneventful. The histopathology report indicated both free soft (confirming the previous report) and hard tissue margins. The surgical ablation was followed by radiotherapy in another institution and according to their files the patient received 66 gray (Gy) locally in 33 fragments and 52 Gy in the neck in 26 fragments. Six months postoperatively the patient presented with osteoradionecrosis of the jaw, a pathologic fracture of the mandibular symphysis and edema of the lower lip. At that time, biopsies were taken, with negative results. The patient refused admission as well as the scheduled hyperbaric oxygen therapy; simultaneously, underwent a complete CT workout (brain, face, neck, chest, upper and lower abdomen), that was negative for pathology (LMS or colon adenocarcinoma). Two months later the IntroductionBenign smooth muscle tumors, or leiomyomas, are common, well-circumscribed neoplasms that can arise from smooth muscle cells anywhere in the body, but are encountered most commonly in the uterus [1]. Leiomyosarcomas (LMS), theirs malignant counterpart, comprise 7% of head and neck sarcomas [2]. Primary LMSs rarely occur in the oral and maxillofacial region, probably due to paucity of smooth muscle tissue in the area [1,3]. Source of smooth muscle in the oral cavity may be the arterial tunica media, lingual duct, circumvallate papillae and pluripotential mesenchymal cells [1]. We present a case of oral LMS which exhibits an uncommon clinical appearance in a non-prevalent site and which also presents difficulties in the histopathologic diagnosis of the incisional biopsy. Case ReportAn 81-year-old Caucasian female attended the outpatient department, complaining of a painless mass in the region of her anterior mandibular ridge, causing difficulty in mastication. On examination the mass measured 4x3x3cm, was bluish-red in color, soft and friable in consistency and boss elated in appearance. The lesion was broad-based and firmly attached to the underlying tissues. The patient was partially edentulous an...

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