Kugimoto Takuma, Yamagata Yuko, Ohsako Toshimitsu, Hirai Hideaki, Nishii Naoto, Kayamori Kou, Ikeda Tohru, Harada Hiroyuki
Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan.
Department of Oral Pathology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku 113-8549, Tokyo, Japan.
World J Clin Cases. 2022 Dec 6;10(34):12742-12749. doi: 10.12998/wjcc.v10.i34.12742.
Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign tumor due to its asymptomatic and indolent clinical course. Here, we report a case of massive low-grade myxoid liposarcoma (MLS) of the floor of the mouth.
A 71-year-old man presented with a huge mass in the left floor of the mouth. A biopsy was performed, and a diagnosis of a myxoid tumor suspicious for low-grade MLS or myxoma was made. Gadolinium-enhanced T1-weighted magnetic resonance imaging showed an intensely enhanced tumor lesion that occupies the left sublingual space and extends to the submandibular space. Submandibular dissection, tumor resection, and reconstruction with a radial forearm flap were performed. The surgical specimen exhibited histologically low-grade MLS. Fused in sarcoma (FUS, also known as TLS) and DNA damage-inducible transcript 3 (DDIT3, also known as CHOP) break-apart was not detected in the fluorescence hybridization analysis. The tumor was completely encapsulated and did not require additional treatment. Furthermore, no recurrence was reported 40 mo after surgery.
We experienced an extremely rare, massive, low-grade MLS emerging from the floor of the mouth. Oftentimes, an MLS of the floor of the mouth lacks significant clinical findings and is often misdiagnosed. Although no FUS-DDIT3 fusion gene was detected, a low-grade MLS was ultimately diagnosed based on the histological findings.
口腔脂肪肉瘤是一种极其罕见的病变,由于其无症状且病程进展缓慢,临床上常被误诊为良性肿瘤。在此,我们报告一例发生于口腔底部的巨大低度黏液样脂肪肉瘤(MLS)病例。
一名71岁男性因左侧口腔底部出现巨大肿物就诊。进行了活检,诊断为疑似低度MLS或黏液瘤的黏液样肿瘤。钆增强T1加权磁共振成像显示肿瘤病变强化明显,占据左侧舌下间隙并延伸至下颌下间隙。实施了下颌下淋巴结清扫、肿瘤切除,并采用桡侧前臂皮瓣进行重建。手术标本经组织学检查显示为低度MLS。荧光杂交分析未检测到肉瘤融合蛋白(FUS,也称为TLS)和DNA损伤诱导转录物3(DDIT3,也称为CHOP)的断裂分离。肿瘤完全被包裹,无需额外治疗。此外,术后40个月未报告复发情况。
我们遇到了一例极其罕见的、发生于口腔底部的巨大低度MLS。通常情况下,口腔底部的MLS缺乏明显的临床症状,常被误诊。尽管未检测到FUS-DDIT3融合基因,但最终根据组织学检查结果诊断为低度MLS。