Open AccessLeiomyoma and Leiomyosarcoma (Primary and Metastatic) of the Oral and Maxillofacial Region: A Clinicopathological and Immunohistochemical Study of 27 Cases
Author(s) -
Gabriela Ribeiro de Araújo,
Sara Ferreira dos Santos Costa,
Ricardo Alves Mesquita,
Ricardo Santiago Gomez,
Jean Nunes dos Santos,
Hélder Antônio Rebelo Pontes,
Bruno Augusto Benevenuto de Andrade,
Mário José Romañach,
Michelle Agostini,
Pablo Agustı́n Vargas,
Cínthia Verónica Bardález López de Cáceres,
Alan Roger SantosSilva,
Ana Carolina Prado Ribeiro,
Thaís Bianca Brandão,
Ramiro Alejandro Tomasi,
R. A. Ferreyra,
Oslei Paes de Almeida,
Felipe Paiva Fonseca
Publication year - 2021
Publication title -
head and neck pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.801
H-Index - 50
eISSN - 1936-0568
pISSN - 1936-055X
DOI - 10.1007/s12105-021-01336-2
Subject(s) - oral and maxillofacial surgery , immunohistochemistry , otorhinolaryngology , medicine , leiomyosarcoma , pathology , leiomyoma , dentistry , surgery
Smooth muscle neoplasms represent an important group of lesions which is rare in the oral cavity. Leiomyoma (LM) is benign smooth muscle/pericytic tumor usually presenting as non-aggressive neoplasm, while leiomyosarcoma (LMS) represents its malignant counterpart. The rarity of these lesions, together with its unspecific clinical presentation and a variable histopathological appearance, lead to a broad list of differential diagnoses, hampering their diagnoses. Therefore, in this study we describe the clinical and microscopic features of a series of oral and maxillofacial LMs and LMSs. A retrospective search from 2000 to 2019 was performed and all cases diagnosed as LM and LMS affecting the oral cavity and gnathic bones were retrieved. Clinical and demographic data were obtained from the patients' pathology records, while microscopic features and immunohistochemistry were reviewed and completed when necessary to confirm the diagnoses. Twenty-two LMs and five LMSs were obtained. In the LM group, males predominated, with a mean age of 45.7 years. The upper lip was the most affected site, and 18 cases were classified as angioleiomyomas and four as solid LM. In the LMS group, females predominated, with a mean age of 47.6 years. The mandible was the most affected site. Diffuse proliferation of spindle cells, with necrosis and mitotic figures, were frequent microscopic findings. LMs and LMSs were positive for α-smooth muscle actin, HHF-35 and h-caldesmon. In conclusion, oral LM/LMS are uncommon neoplasms with the latter usually presenting as metastatic disease. H&E evaluation may be very suggestive of oral LMs, but h-caldesmon staining is strongly recommended to confirm LMS diagnosis.