Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, room 3202 D. Pampulha, Belo Horizonte, MG, CEP: 31.270-901, Brazil.
Department of Stomatology (Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Head Neck Pathol. 2021 Sep;15(3):1031-1040. doi: 10.1007/s12105-020-01242-z. Epub 2020 Oct 22.
Liposarcomas of the oral cavity are rare. Those originating in the buccal mucosa cause challenging diagnostic and therapeutic issues since less than 40 cases of liposarcomas of the buccal mucosa and cheek have been reported in the worldwide literature. Herein, we present a case of atypical lipomatous tumor/well-differentiated liposarcoma affecting a 45-year-old female patient. Ultrasonography and magnetic resonance imaging confirmed a well-defined mass located in the right buccal mucosa, extending to the submucosal layers of the cheek. Histopathologically, a well-differentiated fatty neoplasm with presence of prominent stromal inflammatory cells was observed. Multifocally scattered bizarre hyperchromatic stromal cells, some of which multinucleated, were also observed. An immunohistochemical panel comprising vimentin, S-100, CD10, CD34, CD20, CD3, CD68, CD138, MDM2, Ki-67, and P53 was employed to better characterize the lesion. A local recurrence event occurred during a 10-year follow-up period. Surgical resection was performed during both episodes. We also provided an overview of demographic and clinicopathological characteristics, immunohistochemical features, imaging findings, and the differential diagnosis of liposarcoma of the oral cavity. Knowledge of the etiopathological and clinical aspects of this rare neoplasm is fundamental in order to rule out other conditions, including lipomatous lesions that affect the buccal mucosa.
口腔脂肪肉瘤较为罕见。起源于颊黏膜的脂肪肉瘤会引起具有挑战性的诊断和治疗问题,因为在世界范围内的文献中,仅有不到 40 例颊黏膜和颊部的脂肪肉瘤病例报道。在此,我们报告了一例发生于 45 岁女性的非典型性脂肪性肿瘤/高分化脂肪肉瘤。超声和磁共振成像证实了一个位于右侧颊黏膜的界限清楚的肿块,延伸至颊黏膜的黏膜下层。组织病理学观察到一个分化良好的富含脂肪的肿瘤,伴有明显的基质炎症细胞。还观察到多灶性散在分布的奇异深染的基质细胞,其中一些呈多核。采用包含波形蛋白、S-100、CD10、CD34、CD20、CD3、CD68、CD138、MDM2、Ki-67 和 P53 的免疫组化标志物来更好地对病变进行特征描述。在 10 年的随访期间,出现了局部复发事件。两次手术均行切除术。我们还概述了口腔脂肪肉瘤的人口统计学和临床病理学特征、免疫组织化学特征、影像学表现和鉴别诊断。了解这种罕见肿瘤的病因病理和临床方面对于排除其他疾病(包括影响颊黏膜的脂肪性病变)至关重要。