High-Grade Undifferentiated Pleomorphic Sarcoma of the Tongue: A Case Report

Undifferentiated pleomorphic sarcoma (UPS) is a rare entity that mainly affects the extremities and is uncommon in the head and neck region. Arising from mesenchymal cells with complex genomic alterations, its typical clinical presentation involves a rapidly growing mass in elderly patients. Although surgical resection is the main treatment, high rates of recurrence and metastasis are usually present, requiring radiotherapy or chemotherapy as complementary therapies. We present the case of a 75-year-old female patient with a tongue mass, initially diagnosed as a fibrous tumor and subsequently as a high-grade pleomorphic undifferentiated sarcoma of the tongue. After an initial hemiglossectomy and a second surgery with wide excision, reconstruction, and radiotherapy, no evidence of residual disease was observed at follow-up. Despite developing xerostomia and dysarthria as late side effects of treatment, the patient showed a favorable response to treatment, with regular check-ups revealing no tumor activity until 24 months after treatment. This case highlights the importance of a multidisciplinary approach in the management of tongue sarcoma, showing that a combination of surgery, radiotherapy, and close follow-up can result in the successful control of this pathology, even in highly aggressive cases.