头颈部炎性平滑肌肉瘤：病例报告
Inflammatory leiomyosarcoma of the head and neck: Case report.
作者信息
Viljoen Nandi, Viljoen Gerrit, Fagan Johannes J, Govender Dhirendra
机构信息
Division of Anatomical Pathology, Faculty of Health Sciences, University of Cape Town, South Africa; National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.
Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa.
出版信息
Int J Surg Case Rep. 2021 May;82:105907. doi: 10.1016/j.ijscr.2021.105907. Epub 2021 Apr 27.
INTRODUCTION AND IMPORTANCE
Primary sarcomas in the head and neck region are rare. Inflammatory leiomyosarcoma was first described in 1995. The case reported herein is the first reported inflammatory leiomyosarcoma occurring in the head and neck.
PRESENTATION OF CASE
A 37-year-old male presented with a long history of an asymptomatic slowly enlarging neck mass. Examination revealed a firm mass in the lower third of the right sternocleidomastoid muscle. Computerized tomography and magnetic resonance imaging showed a lobulated, well-circumscribed tumour with malignant features. A wide local excision was performed and histopathological examination confirmed an inflammatory leiomyosarcoma.
DISCUSSION
Inflammatory leiomyosarcoma is a recently described peculiar soft tissue tumour with histological features overlapping conventional leiomyosarcoma, and dense lymphocytic inflammation and immunohistochemical reactivity for both smooth and skeletal muscle markers. These are indolent tumours and wide local excision is curative.
CONCLUSION
This case highlights the importance of considering primary sarcomas in the differential diagnosis of asymptomatic head and neck masses.
引言与重要性
头颈部原发性肉瘤较为罕见。炎性平滑肌肉瘤于1995年首次被描述。本文报道的病例是首例发生于头颈部的炎性平滑肌肉瘤。
病例介绍
一名37岁男性，有长期无症状的颈部肿物缓慢增大病史。检查发现右侧胸锁乳突肌下三分之一处有一质地坚硬的肿物。计算机断层扫描和磁共振成像显示为分叶状、边界清晰的具有恶性特征的肿瘤。进行了广泛的局部切除，组织病理学检查确诊为炎性平滑肌肉瘤。
讨论
炎性平滑肌肉瘤是一种最近描述的特殊软组织肿瘤，其组织学特征与传统平滑肌肉瘤重叠，伴有密集的淋巴细胞炎症以及对平滑肌和骨骼肌标志物的免疫组化反应性。这些是惰性肿瘤，广泛局部切除可治愈。
结论
本病例强调了在无症状头颈部肿物的鉴别诊断中考虑原发性肉瘤的重要性。
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