Dry S M, Jorgensen J L, Fletcher C D
Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Histopathology. 2000 Mar;36(3):210-20. doi: 10.1046/j.1365-2559.2000.00814.x.
Oral leiomyosarcoma is rare and poorly documented. We aimed to characterize these lesions clinicopathologically in order to facilitate their distinction from other spindle cell neoplasms in the oral cavity.
Ten cases of oral leiomyosarcoma were retrieved and studied histologically and immunohistochemically. Clinical data were obtained from referring pathologists and prior literature concerning 46 comparable cases was reviewed. Nine out of 10 cases occurred in adults; 50% arose in the jaws and four showed bone involvement. Histological appearances were similar to leiomyosarcomas elsewhere. In addition to myogenic markers, two cases were also keratin-positive. Four patients developed local recurrence or metastatic disease and three died of tumour (median follow-up 37 months).
Leiomyosarcoma is under-recognized in the mouth, often being mistaken for a spindle-celled epithelial neoplasm. Aside from an unusual but infrequent tendency to spread to lymph nodes and a location-specific differential diagnosis, its clinicopathological features are comparable to leiomyosarcomas at other locations.
口腔平滑肌肉瘤罕见且文献记载较少。我们旨在对这些病变进行临床病理特征分析，以便于将其与口腔内其他梭形细胞肿瘤相鉴别。
收集10例口腔平滑肌肉瘤病例，进行组织学和免疫组织化学研究。从送检病理学家处获取临床资料，并复习了之前有关46例类似病例的文献。10例病例中有9例发生于成年人；50%发生于颌骨，4例显示有骨受累。组织学表现与其他部位的平滑肌肉瘤相似。除了肌源性标志物外，2例还呈角蛋白阳性。4例患者出现局部复发或转移性疾病，3例死于肿瘤（中位随访37个月）。
平滑肌肉瘤在口腔中未得到充分认识，常被误诊为梭形细胞上皮肿瘤。除了转移至淋巴结的罕见倾向和特定部位的鉴别诊断外，其临床病理特征与其他部位的平滑肌肉瘤相似。
