Abstract
Epithelioid sarcoma is classified as a group of malignant soft tissue tumors with undetermined differentiation direction in the 2020 WHO classification of soft tissue tumors. It is characterized by slow growth but high recurrence and metastasis rates, and unlike most soft tissue sarcomas, it tends to metastasize to the lymph nodes. Extensive resection is the first line of treatment. Epithelioid sarcoma is most frequently found in the distal upper extremities of young adults, with occurrences in the oral cavity being extremely rare. Herein, we report a case of small epithelioid sarcoma arising in the soft tissue of the lower lip.
The patient, a 62-year-old female, became aware of induration of the left lower lip around June 2018. At the time of the initial examination, a hard, 5-mm-diameter, elastic nodule with somewhat unclear borders was found under the mucosa of the left lower lip. Based on the findings of an open biopsy under local anesthesia, the histopathological diagnosis was epithelioid sarcoma. Computed tomography （CT）, magnetic resonance imaging, and positron emission tomography-CT showed no neck or distant metastasis. In February 2019, she underwent wide lower lip excision, left radical neck dissection （type Ⅲ）, and left forearm skin valve reconstruction under general anesthesia. Five courses of AI therapy （doxorubicin＋ifosfamide） were then administered at the Department of Musculoskeletal Oncology at our hospital. Two years have passed since the surgery, and the patient is now doing well with no recurrence or metastasis.
