High Grade Sarcoma of the Oral Cavity in a Young Adult Female:  a Case Report

Candice  Q. Ansorge,; Efraim Jeric  T. Eustacio,

High Grade Sarcoma of the Oral Cavity in a Young Adult Female: a Case Report

Efraim Jeric T Eustacio | Candice Que Ansorge

Abstract:

Objective: To report a rare case of a high-grade sarcoma in the maxillary alveolus in a young adult patient and to discuss the diagnostic approach using immunohistochemical staining. Methodology Design: Case report Setting: Tertiary hospital Patient: 1 Case Report A.G., a 27-year-old female consulted due to a right maxillary alveolar mass. Eight months ago, the patient experienced loose dentitions and teeth extraction on maxillary 2nd premolar, 1st and 2nd molar on the right was done. Four months prior to consult, a 2x2cm irregular mass was noted on the right maxillary alveolar ridge with minimal yellowish discharge. She was given unrecalled antibiotic with no improvement. During the interim, there was notable increase in the size, measuring 5x4cm, exophytic, irregularly bordered, tender, with yellowish discharge and associated with difficulty in opening her mouth. The patient consulted our institution wherein biopsy revealed spindle cell neoplasm. Immunohistochemical staining using Ki67, S100 and SMA confirmed high grade sarcoma. Conclusion Sarcoma is a rare tumor more commonly occurring in the extremities of young women. Although very uncommon, it may also present as a painful fast-growing mass in the oral cavity. Immunohistochemical staining such as Ki67, SMA and S-100 plays a big role in its diagnosis.

References:

Fletcher CD, Bridge JA, Hogendoorn PC, Mertens F. 4^th. Lyon, France: IARC Press; 2013. WHO Classification of Tumours of Soft Tissue and Bone. [Google Scholar ]
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65:5–29. [PubMed ] [Google Scholar ]
Hui JY. Epidemiology and etiology of sarcomas. Surg Clin North Am. 2016;96:901–14. [PubMed ] [Google Scholar ]
Zagars GK, Ballo MT, Pisters PW, Pollock RE, Patel SR, Benjamin RS, et al. Prognostic factors for patients with localized soft-tissue sarcoma treated with conservation surgery and radiation therapy: An analysis of 1225 patients. Cancer. 2003;97:2530–43. [PubMed ] [Google Scholar ]
Salo JC, Lewis JJ, Woodruff JM, Leung DH, Brennan MF. Malignant fibrous histiocytoma of the extremity. Cancer. 1999;85:1765–72. [PubMed ] [Google Scholar ]
Choong PF, Gustafson P, Willén H, Akerman M, Baldetrop B, Fernö M, et al. Prognosis following locally recurrent soft-tissue sarcoma. A staging system based on primary and recurrent tumour characteristics. Int J Cancer. 1995;60:33-7
Serrano C, George S. Leiomyosarcoma. Hematol Oncol Clin North Am. 2013 Oct;27(5):957-74. [PubMed ]
Martin-Liberal J. Leiomyosarcoma: Principles of management. Intractable Rare Dis Res. 2013 Nov;2(4):127-9. [PMC free article ] [PubMed ]
Ip PP, Cheung AN. Pathology of uterine leiomyosarcomas and smooth muscle tumours of uncertain malignant potential. Best Pract Res Clin Obstet Gynaecol. 2011 Dec;25(6):691-704. [PubMed ]
Wang WL, Soslow R, Hensley M, Asad H, Zannoni GF, de Nictolis M, Branton P, Muzikansky A, Oliva E. Histopathologic prognostic factors in stage I leiomyosarcoma of the uterus: a detailed analysis of 27 cases. Am J Surg Pathol. 2011 Apr;35(4):522-9. [PubMed ]
Yadav R, Bharathan S. Leiomyosarcoma of the buccal mucosa: a case report with immunohistochemistry findings. J Oral Sci. 2008;50(2):215–18. [PubMed ] [Google Scholar ]
Yan B, Li Y, Pan J, Xia H, Li LJ. Primary oral leiomyosarcoma: a retrospective clinical analysis of 20 cases. Oral Dis. 2010;16(2):198–203. [PubMed ] [Google Scholar ]
Khan AM, Topilow AA. S100. PathologyOutlines.com website.https://www.pathologyoutlines.com/topic/stainss100.html. Accessed February 19^th, 2023.
Kösemehmetoğlu K, Johnson G. Actin, alpha smooth muscle type. PathologyOutlines.com website.https://www.pathologyoutlines.com/topic/stainsalphasmoothmuscleactin.ht ml. Accessed February 19^th, 2023.
Hoos A, et.al. High Ki-67 proliferative index predicts disease specific survival in patients with high-risk soft tissue sarcomas. https://doi.org/10.1002/1097-0142 (20010815)92:4<869::AID CNCR1395>3.0.CO;2 -U