Primary oral leiomyosarcoma: A systematic review and update

Abstract

The aim of this systematic review was to address the clinicopathologic inconsistencies noted with primary oral leiomyosarcoma in the literature by amassing the available data published into a comprehensive analysis. Eligibility criteria included publications of cases with dedicated immunohistochemical work‐up along with radiographs to evaluate location. Based on these criteria, the systematic review compiled 29 cases. Four primary location sites were identified in the reported cases: soft tissue presentation only, soft tissue with bony involvement, bony involvement only, and bony involvement with a soft tissue component. The majority of primary oral leiomyosarcoma cases reviewed showed a soft tissue predilection, which is in contrast to prior reports of jawbones being the most common site. In addition, there was an improved 5‐year survival rate for primary oral leiomyosarcoma limited to the oral cavity and gnathic bones without extension into paranasal sinuses.

Leiomyosarcoma of the jaw: case series

“…There was also one unusual case found in the buccal area of the temporomandibular joint. However, Ko 17 reported that the most common location for primary oral leiomyosarcoma seems to be soft tissue, and not the jawbones, as frequently reported. Further research is needed to clarify this point.…”

Myofibroblastic sarcoma of the oral cavity: a diagnostic dilemma and report of two cases

“…However, oral and maxillofacial leiomyosarcoma has been reported in several sites, including the mandible, tongue, and buccal mucosa, in patients aged between seven to 67 years. Soft tissue lesions present as pedunculated soft tissue mass [16]. The tumour cells exhibit blunt-ended cigar nuclei, deeply eosinophilic fibrillary cytoplasm, and perinuclear vacuoles, arranged in a fascicular pattern [17].…”

Primary oral leiomyosarcoma of the maxillary bone and sinus: case report and up-to-date review of literature

“…Leiomyosarcoma is a malignant tumor of smooth muscle derivation which account for 5%---10% of all soft tissue sarcomas. 3,10 LMS frequently affects the retro-peritoneal region, the uterus and the gastrointestinal tract. 1,11 Oral LMS are extremely rare, accounting for 0.64% of all LMS and for 5.7% of head and neck LMS.…”

“…1 Due to the lack of smooth muscle tissue in the oral cavity, it has been suggested that LMS arise from smooth muscle cells of the blood vessel walls, circumvallate papillae of the tongue, neuromuscular bundles, myoepithelial cells or pluripotent undifferentiated mesenchymal cells. 1,3,4 Clinically, sarcomas of the oral cavity show nonspecific signs and symptoms and can appear as primary tumors, radiation-associated tumors or metastatic tumors. 1,4,5 Biopsy, histological examination and immunohistochemical staining are mandatory to achieve a definitive diagnosis.…”