Lingual Leiomyosarcoma: A Histopathological Case Report.

Area of Science:

• Oncology
• Pathology
• Surgical Oncology

Background:

• Leiomyosarcomas, rare smooth muscle neoplasms, typically occur in the reproductive system, GI tract, or subcutaneous tissues.
• Their occurrence in the head and neck, particularly the tongue, is exceptionally rare due to limited smooth muscle presence.

Observation:

• A 60-year-old male presented with a slow-growing, painless mass on the right lateral tongue margin.
• Histopathology revealed pleomorphic spindle cells with bizarre nuclei, high mitotic activity, and fascicular growth pattern.
• Initial differential diagnosis included sarcomatoid squamous cell carcinoma due to patient demographics and risk factors.

Findings:

• Immunohistochemistry was crucial for definitive diagnosis, differentiating the tumor from epithelial malignancies.
• The tumor was negative for pan-cytokeratin and desmin, focally positive for caldesmon, and positive for smooth muscle actin.
• These markers confirmed the diagnosis of pleomorphic leiomyosarcoma of the tongue.

Implications:

• This case highlights the importance of comprehensive histopathological and immunohistochemical evaluation for rare tongue malignancies.
• Accurate diagnosis is vital for appropriate treatment planning and patient management of leiomyosarcoma.
• Understanding the rare presentation of leiomyosarcoma in the oral cavity can aid clinicians in recognizing and diagnosing similar cases.