A case of leiomyosarcoma arising in the maxilla

Abstract

We report on a 33-year-old woman who presented with swelling of the maxillary tuberosity. Leiomyosarcoma was histopathologically diagnosed on biopsy. A review of the literature is also provided.
In April 2004, the patient visited a dental clinic because of gingival swelling around a right maxillary molar. Because the swelling around the right maxillary second molar was not improved by endodontic treatment, the patient was referred to our department on December M, 2004. At initial examination, bony enlargement of a right maxillary tuberosity was found. Orthopantomography revealed a mixed radiolucent/radio-opaque lesion involving the impacted third molar of the right maxilla. MR imaging showed heterogeneous signal intensity around the tooth. On March M, 2005, the lesion was diagnosed as a leiomyosarcoma on biopsy. On April 1, the tumor was surgically resected under general anesthesia. Thick and fascicular bundles of spindle cells with advanced atypia were recognized on examination of hematoxylin and eosin-stained sections. Anti-smooth muscle actin and HHF 35 were positive in the tumor cells on immunostaining. These findings confirmed the pathological diagnosis of leiomyosarcoma. At present, 11 months have passed since the operation, and neither recurrence nor metastasis has been detected.