Primary and secondary leiomyosarcoma of the oral and perioral region--clinicopathological and immunohistochemical analysis of a rare entity with a review of the literature

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Primary and secondary leiomyosarcoma of the oral and perioral region--clinicopathological and immunohistochemical analysis of a rare entity with a review of the literature. / Schütz, Anja; Smeets, Ralf; Driemel, Oliver; Hakim, Samer George; Kosmehl, Hartwig; Hanken, Henning; Kolk, Andreas.

In: J ORAL MAXIL SURG, Vol. 71, No. 6, 01.06.2013, p. 1132-42.

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@article{27f02a03622245e3837b6fe6c5fde246,
title = "Primary and secondary leiomyosarcoma of the oral and perioral region--clinicopathological and immunohistochemical analysis of a rare entity with a review of the literature",
abstract = "PURPOSE: Leiomyosarcoma (LMS) rarely occurs in the head and neck region. These tumors present with a wide range of clinical features, so the diagnosis is predicated on conventional microscopic findings coupled with immunohistochemical analysis.PATIENTS AND METHODS: Clinical and histologic data of 7 patients with LMS of the head and neck were recorded retrospectively. In addition to routine immunohistochemistry, staining for cell cycle regulator proteins p16 and p21 was performed.RESULTS: Five LMSs (4 intraoral, 1 dermal cheek) occurred primarily in the oral and perioral region. Two LMSs (parietal and sinonasal) were diagnosed as metastases originating from the uterus and pelvis. Treatment of the primary LMSs consisted of radical tumor resection with clear margins. Distant metastases from LMSs were irradiated or excised as palliative treatment. Three of 5 patients (60%) with primarily excised LMS developed recurrence after an average of 7 months, with lung metastases occurring after 17 months. In 1 patient, cervical lymph node metastases were detected after 10 months. Of all patients, 5 died after an average survival period of 2.4 years. The mean survival period of the 5 patients with primary LMS of the head and neck was 3.3 years. All tumors were positive for vimentin and α-smooth muscle actin, with 57% of tumors showing positive nuclear expression of p16 and 71% of p21. Lack of p16 nuclear expression was associated with a shorter mean survival time (1.3 vs 4.3 yr for p16 positivity).CONCLUSION: Lung and cervical lymph node metastases often occur in LMS of the head and neck. Presurgical staging, including gynecologic examination, whole-body computed tomography, and sometimes positron-emission or computed tomography, to rule out LMS metastasis is mandatory. Surgical resection of the tumor should be given top priority. Lack of p16 reactivity may have a prognostic value for LMS because it was related to a trend toward poorer survival.",
keywords = "Actins, Adult, Aged, Aged, 80 and over, Cell Cycle Proteins, Cyclin-Dependent Kinase Inhibitor p16, Cyclin-Dependent Kinase Inhibitor p21, Desmin, Facial Neoplasms, Female, Humans, Ki-67 Antigen, Leiomyosarcoma, Male, Mouth Neoplasms, Pelvic Neoplasms, Retrospective Studies, Survival Analysis, Uterine Neoplasms, Vimentin",
author = "Anja Sch{\"u}tz and Ralf Smeets and Oliver Driemel and Hakim, {Samer George} and Hartwig Kosmehl and Henning Hanken and Andreas Kolk",
note = "Copyright {\textcopyright} 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.",
year = "2013",
month = jun,
day = "1",
doi = "10.1016/j.joms.2012.12.011",
language = "English",
volume = "71",
pages = "1132--42",
journal = "J ORAL MAXIL SURG",
issn = "0278-2391",
publisher = "W.B. Saunders Ltd",
number = "6",

}

RIS

TY - JOUR

T1 - Primary and secondary leiomyosarcoma of the oral and perioral region--clinicopathological and immunohistochemical analysis of a rare entity with a review of the literature

AU - Schütz, Anja

AU - Smeets, Ralf

AU - Driemel, Oliver

AU - Hakim, Samer George

AU - Kosmehl, Hartwig

AU - Hanken, Henning

AU - Kolk, Andreas

N1 - Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

PY - 2013/6/1

Y1 - 2013/6/1

N2 - PURPOSE: Leiomyosarcoma (LMS) rarely occurs in the head and neck region. These tumors present with a wide range of clinical features, so the diagnosis is predicated on conventional microscopic findings coupled with immunohistochemical analysis.PATIENTS AND METHODS: Clinical and histologic data of 7 patients with LMS of the head and neck were recorded retrospectively. In addition to routine immunohistochemistry, staining for cell cycle regulator proteins p16 and p21 was performed.RESULTS: Five LMSs (4 intraoral, 1 dermal cheek) occurred primarily in the oral and perioral region. Two LMSs (parietal and sinonasal) were diagnosed as metastases originating from the uterus and pelvis. Treatment of the primary LMSs consisted of radical tumor resection with clear margins. Distant metastases from LMSs were irradiated or excised as palliative treatment. Three of 5 patients (60%) with primarily excised LMS developed recurrence after an average of 7 months, with lung metastases occurring after 17 months. In 1 patient, cervical lymph node metastases were detected after 10 months. Of all patients, 5 died after an average survival period of 2.4 years. The mean survival period of the 5 patients with primary LMS of the head and neck was 3.3 years. All tumors were positive for vimentin and α-smooth muscle actin, with 57% of tumors showing positive nuclear expression of p16 and 71% of p21. Lack of p16 nuclear expression was associated with a shorter mean survival time (1.3 vs 4.3 yr for p16 positivity).CONCLUSION: Lung and cervical lymph node metastases often occur in LMS of the head and neck. Presurgical staging, including gynecologic examination, whole-body computed tomography, and sometimes positron-emission or computed tomography, to rule out LMS metastasis is mandatory. Surgical resection of the tumor should be given top priority. Lack of p16 reactivity may have a prognostic value for LMS because it was related to a trend toward poorer survival.

AB - PURPOSE: Leiomyosarcoma (LMS) rarely occurs in the head and neck region. These tumors present with a wide range of clinical features, so the diagnosis is predicated on conventional microscopic findings coupled with immunohistochemical analysis.PATIENTS AND METHODS: Clinical and histologic data of 7 patients with LMS of the head and neck were recorded retrospectively. In addition to routine immunohistochemistry, staining for cell cycle regulator proteins p16 and p21 was performed.RESULTS: Five LMSs (4 intraoral, 1 dermal cheek) occurred primarily in the oral and perioral region. Two LMSs (parietal and sinonasal) were diagnosed as metastases originating from the uterus and pelvis. Treatment of the primary LMSs consisted of radical tumor resection with clear margins. Distant metastases from LMSs were irradiated or excised as palliative treatment. Three of 5 patients (60%) with primarily excised LMS developed recurrence after an average of 7 months, with lung metastases occurring after 17 months. In 1 patient, cervical lymph node metastases were detected after 10 months. Of all patients, 5 died after an average survival period of 2.4 years. The mean survival period of the 5 patients with primary LMS of the head and neck was 3.3 years. All tumors were positive for vimentin and α-smooth muscle actin, with 57% of tumors showing positive nuclear expression of p16 and 71% of p21. Lack of p16 nuclear expression was associated with a shorter mean survival time (1.3 vs 4.3 yr for p16 positivity).CONCLUSION: Lung and cervical lymph node metastases often occur in LMS of the head and neck. Presurgical staging, including gynecologic examination, whole-body computed tomography, and sometimes positron-emission or computed tomography, to rule out LMS metastasis is mandatory. Surgical resection of the tumor should be given top priority. Lack of p16 reactivity may have a prognostic value for LMS because it was related to a trend toward poorer survival.

KW - Actins

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cell Cycle Proteins

KW - Cyclin-Dependent Kinase Inhibitor p16

KW - Cyclin-Dependent Kinase Inhibitor p21

KW - Desmin

KW - Facial Neoplasms

KW - Female

KW - Humans

KW - Ki-67 Antigen

KW - Leiomyosarcoma

KW - Male

KW - Mouth Neoplasms

KW - Pelvic Neoplasms

KW - Retrospective Studies

KW - Survival Analysis

KW - Uterine Neoplasms

KW - Vimentin

U2 - 10.1016/j.joms.2012.12.011

DO - 10.1016/j.joms.2012.12.011

M3 - SCORING: Journal article

C2 - 23434173

VL - 71

SP - 1132

EP - 1142

JO - J ORAL MAXIL SURG

JF - J ORAL MAXIL SURG

SN - 0278-2391

IS - 6

ER -