Nascimento Alessandra F, McMenamin Máirín E, Fletcher Christopher D M
Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Ann Diagn Pathol. 2002 Apr;6(2):83-93. doi: 10.1053/adpa.2002.32375.
Liposarcomas in the oral cavity have rarely been described, with less than 50 reported cases to date and a purported predominance of the myxoid type. We reviewed our experience with 23 atypical lipomatous tumors/liposarcomas of the oral cavity. Twelve patients were men, 10 were women, and gender was not stated in one case. Age at presentation ranged from 28 to 83 years (median, 49.5 years). The most commonly affected site was the tongue and most cases presented as a slowly growing, painless mass. The clinical impression was lipoma or fibroma in the majority of cases. Tumor size ranged from 0.6 to 8.0 cm (median, 1.5 cm). Five cases were well circumscribed, 5 cases were focally infiltrative, and 13 cases had markedly infiltrative margins. Twenty-one cases were classified as atypical lipomatous tumors (of which 10 showed spindle cell features), one as dedifferentiated liposarcoma, and one as myxoid liposarcoma. Follow-up data was available in 13 of the 23 cases. Five others were lost to follow-up after a short period. Eleven patients remained free of disease without local recurrence or metastasis during the period of follow-up that ranged from 10 months to 9 years (median, 24 months). Two patients had multiple local recurrences. Our study shows that atypical lipomatous tumor is the most common type of malignant fatty tumor to arise in the oral cavity with an apparently low risk of recurrence if widely excised, although follow-up is relatively limited thus far.
口腔脂肪肉瘤鲜有报道，迄今为止报告病例不足50例，据称黏液样型占多数。我们回顾了23例口腔非典型脂肪瘤/脂肪肉瘤的诊治经验。12例为男性，10例为女性，1例未说明性别。就诊时年龄范围为28至83岁（中位数为49.5岁）。最常受累部位是舌，多数病例表现为生长缓慢的无痛性肿块。大多数病例临床诊断为脂肪瘤或纤维瘤。肿瘤大小范围为0.6至8.0 cm（中位数为1.5 cm）。5例边界清晰，5例呈局灶性浸润，13例边界明显浸润。21例被分类为非典型脂肪瘤（其中10例具有梭形细胞特征），1例为去分化脂肪肉瘤，1例为黏液样脂肪肉瘤。23例中有13例有随访数据。另外5例在短期内失访。11例患者在10个月至9年（中位数为24个月）的随访期内无疾病复发，无局部复发或转移。2例患者有多次局部复发。我们的研究表明，非典型脂肪瘤是口腔最常见的恶性脂肪肿瘤类型，如果广泛切除，复发风险明显较低，尽管迄今为止随访相对有限。
