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Hamid R, Chalkoo A, Tariq S, Bilal S, Wani S. Central angioleiomyoma of the mandible: A rare entity. J Cancer Res Ther 2020; 16:647-652. [PMID: 32719283 DOI: 10.4103/jcrt.jcrt_960_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The leiomyoma is a benign smooth-muscle neoplasm commonly found in the female genital tract, gastrointestinal tract, or skin. Leiomyomas of the oral cavity are unusual. Oral leiomyomas are uncommon due to the paucity of the smooth muscle in the mouth (except in blood vessels) and thus the involvement of jaw bones is extremely rare. Leiomyomas have been classified as solid angiomyoma, angioleiomyoma (vascular leiomyoma), and epithelioid variants. Angioleiomyomas are benign mesenchymal tumors derived from smooth muscle, which rarely occur in the oral cavity. Malignant transformation probably does not occur but careful histopathologic examination is still necessary to differentiate these benign lesions from their malignant counterparts due to different prognosis. Although uncommon in the maxilla and mandible, they should be included in the differential diagnosis of radiolucent lesions of jaw bones. An extensive search of literature was carried out on the Medline-PubMed and Google Scholar database using the keywords such as leiomyoma, angioleiomyoma, jaw bones, maxilla, mandible, intra-osseous to thoroughly search and collect all the reported cases of intraosseous leiomyoma (but our search was not limited to these terms only). To the best of our knowledge, only 23 cases of intraosseous leiomyomas have been reported so far in the jaw bones, among which only 8 belonged to angioleiomyomas. Herein, we report the 9th case of intraosseous angioleiomyoma, one of the variants of leiomyoma and overall 24th intraosseous leiomyoma in a 6-year-old female child, together with conventional histopathologic and immunohistochemical findings.
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Affiliation(s)
- Rizwan Hamid
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India
| | - Altaf Chalkoo
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India
| | - Saima Tariq
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India
| | - Sheikh Bilal
- Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India
| | - Suhail Wani
- Department of Pathology, SKIMS, Srinagar, Jammu and Kashmir, India
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Rawal SY, Rawal YB. Angioleiomyoma (Vascular Leiomyoma) of the Oral Cavity. Head Neck Pathol 2017; 12:123-126. [PMID: 28589436 PMCID: PMC5873482 DOI: 10.1007/s12105-017-0827-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 05/24/2017] [Indexed: 11/27/2022]
Abstract
A 70-year-old male presented with a slow growing, dome shaped and painless mass of the hard palate. The mass was excised. Histopathological examination confirmed the diagnosis of a angioleiomyoma (vascular leiomyoma). A leiomyoma is an uncommon benign tumor of smooth muscle differentiation. True leiomyomas of the oral cavity are rare and most oral tumors are derived from the smooth muscle of walls of blood vessels. Therefore, they are called vascular leiomyomas or angioleiomyomas. Clinically, they may resemble a myriad other conditions both benign and malignant. A definitive diagnosis depends upon histopathological examination of the biopsied tissue in correlation with the tumor cell immunohistochemistry. Tumors are excised and recurrence is rare. The histopathological findings and differential diagnosis of a case of a palatal angioleiomyoma are discussed.
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Affiliation(s)
- Swati Y. Rawal
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Yeshwant B. Rawal
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Washington, B-204 Magnuson Health Sciences Center, 1959 NE Pacific Street, Box 357133, Seattle, WA 98195 USA
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Dutt KC, Bindra S, Awana M, Talwar M, Lehl G. Intraosseous Leiomyoma of the Mandible: A Case Report of the Rare Entity and Review of Literature. J Maxillofac Oral Surg 2017; 16:145-151. [PMID: 28439152 PMCID: PMC5385679 DOI: 10.1007/s12663-016-0934-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 06/17/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Leiomyoma is a rare tumor of smooth muscle origin with a very low incidence in the maxillofacial region. Intraosseous occurrence of oral leiomyoma is even rare with involvement of mandible followed by maxilla. AIM The purpose of this paper is to present a case of intraosseous leiomyoma of the left mandibular angle region with the review of literature describing this rare entity. The paper also highlights the need to include this entity in differential diagnoses of jaw lesions. MATERIAL AND METHOD An extensive search of literature was carried out on the Medline-Pubmed and Google Scholar database using the keywords leiomyoma, maxilla, mandible, oral and palate to thoroughly search and collect all the reported cases of intraosseous leiomyoma. RESULT To the best of our knowledge till date only 22 cases of intraosseous leiomyoma have been reported in the maxillomandibular region we represent the 23rd case of the intraosseous leiomyoma in a 36 year old male patient. CONCLUSION Though uncommon but it is known to occur in the jaws therefore intraosseous leiomyoma should be included in the list of differential diagnoses of radiolucent lesion of mandible and maxilla.
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Affiliation(s)
- Kirti Chaudhry Dutt
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, 342005 India
| | - Sukhvinder Bindra
- Department of Oral and Maxillofacial Surgery, Army College of Dental Sciences, Secunderabad, India
| | - Meenakshi Awana
- Department of Dentistry, Government Medical College and Hospital, Sec – 32, Chandigarh, 160030 India
| | - Manjit Talwar
- Department of Dentistry, Government Medical College and Hospital, Sec – 32, Chandigarh, 160030 India
| | - Gurvanit Lehl
- Department of Dentistry, Government Medical College and Hospital, Sec – 32, Chandigarh, 160030 India
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Intraosseous angioleiomyoma the tibia: a case report. Pathol Res Pract 2014; 210:321-4. [PMID: 24635970 DOI: 10.1016/j.prp.2014.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 12/03/2013] [Accepted: 01/29/2014] [Indexed: 11/20/2022]
Abstract
Angioleiomyoma (vascular leiomyoma/angiomyoma) is a morphologically distinctive tumor characterized by proliferating smooth muscle cells admixed with prominent vascular elements. The majority of angioleiomyomas involve the superficial soft tissues. Examples of this lesion originating in bone, particularly in the appendicular skeleton, are extremely rare. The present report details the clinicopathologic features of an unusual case of an intraosseous angioleiomyoma arising in the distal tibia. The skeletal tumor exhibited the typical histologic appearance and immunophenotypic features of this entity. Due to its rarity, angioleiomyoma of bone can pose problems in diagnosis. Awareness that angioleiomyoma can present as a primary intraosseous lesion is important so as not to confuse this neoplasm with more commonly encountered bone tumors.
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Ben Slama L, Zaghbani A, Hidaya S. [Jaw muscle tumors]. ACTA ACUST UNITED AC 2009; 110:335-7. [PMID: 19836039 DOI: 10.1016/j.stomax.2009.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Accepted: 07/27/2009] [Indexed: 11/18/2022]
Abstract
Muscular tumors are rare. They hardly ever present in jaws. Rhabdomyoma have never been reported in this localization. Clinical and radiological features are non-specific. The diagnosis is based on histopathological features. It is difficult to make for leiomyosarcoma. Surgical excision is the recommended treatment, conservative for leiomyoma, radical for other malignant tumors. Rhabdomyosarcoma has a good prognosis unlike leiomyosarcoma.
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Affiliation(s)
- L Ben Slama
- Service de chirurgie maxillofaciale et stomatologie, hôpital Adulte de la Pitié-Salpêtrière, université Pierre-et-Marie-Curie, Paris 6, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
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Liang H, Frederiksen NL, Binnie WH, Cheng YS. Intraosseous oral leiomyoma: systematic review and report of one case. Dentomaxillofac Radiol 2004; 32:285-90. [PMID: 14709601 DOI: 10.1259/dmfr/22632903] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The objectives of this study were to report one case of intraosseous oral leiomyoma and to systematically review the English literature. METHODS The clinical and radiographic findings of a patient who presented with intraosseous oral leiomyoma were recorded. In addition, 11 references from the English literature that reported 12 patients were reviewed. RESULTS Thirteen patients (age range 8 months to 71 years; mean 36 years, median 25 years) were reported to present with intraosseous oral leiomyoma. After excluding one patient whose sex was not reported, there were five female patients (42%) and seven males (58%). The majority of patients presented with either no symptoms or with an asymptomatic swelling. Eleven of 13 lesions occurred in the mandible; the most common site was the posterior of the jaw. Radiographically, intraosseous oral leiomyoma was found to present as either a unilocular or multilocular radiolucency with either well defined or ill defined borders and frequent cortical involvement. CONCLUSIONS Intraosseous oral leiomyoma was found to occur in the mandibular posterior region of relatively young patients, with cortical involvement and a slight male gender preference. Surgical excision was the treatment of choice and no recurrence has been encountered.
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Affiliation(s)
- H Liang
- Department of Diagnostic Sciences, Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas, Texas 7526-0677, USA.
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Bertolini F, Bianchi B, Corradi D, Caradonna L, Sesenna E. Mandibular intraosseous leiomyoma in a child: report of a case. J Clin Pediatr Dent 2003; 27:385-7. [PMID: 12924741 DOI: 10.17796/jcpd.27.4.xv5qlv58602q9l37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Leiomyoma is a benign tumor of smooth muscle origin that rarely occurs in the oral cavity. Of the 118 cases occurring in the oral cavity described since 1884, only five involved the mandible. This is a case of an intraosseous leiomyoma in a 9-year old child, who presented to our attention with a firm intraoral mass, involving the angle and the posterior portion of the left mandibular body. The patient was treated with local incision alone, preserving the permanent dental germs and the left inferior alveolar nerve. He remained disease free with regular follow-up for 40 months.
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Affiliation(s)
- Federica Bertolini
- Department of Maxillofacial Surgery, University Hospital of Parma, Italy.
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Brooks JK, Nikitakis NG, Goodman NJ, Levy BA. Clinicopathologic characterization of oral angioleiomyomas. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:221-7. [PMID: 12221390 DOI: 10.1067/moe.2002.125276] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to better define the clinicopathologic features of oral angioleiomyomas. STUDY DESIGN A retrospective search was performed for angioleiomyomas among all smooth muscle tumors accessioned from 1963 to 2001 in an oral pathology service. Twelve lesions met histopathologic criteria for inclusion in the study and were combined with 97 additional cases identified from the English language literature, yielding 109 cases for evaluation. RESULTS The mean age of the patients with oral angioleiomyomas was 45.0 years, with a 1.43:1 male to female predilection. The most frequently reported site was the lip, in 48.6% of patients, followed by the palate (21.1%), buccal mucosa and tongue (each 9.2%), mandible (8.3%), and buccal sulcus, labial sulcus, floor of mouth, and gingiva (each 0.9%). Most mucosal lesions varied in size from a few millimeters to 2 cm, with most central lesions of the mandible measuring greater than 2 cm. Although angioleiomyomas are vascular lesions, only 55.9% of cases appeared red, blue, or purple; the remainder were gray, white, or the color of normal mucosa. Tumors were typically described as painless and manifested a low growth rate. All lesions were well circumscribed and composed of numerous vascular spaces surrounded by thick smooth muscle walls. CONCLUSION Oral angioleiomyomas are benign smooth muscle tumors with a limited degree of morbidity. Careful histologic inspection is necessary to distinguish these lesions from their malignant counterpart, the leiomyosarcoma. Surgical excision is the treatment of choice, and recurrence is rarely encountered.
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Affiliation(s)
- John K Brooks
- Department of Diagnostic Sciences and Pathology, Baltimore College of Dental Surgery, Dental School, University of Maryland, Baltimore, 21201-1586, USA.
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Baden E, Doyle JL, Lederman DA. Leiomyoma of the oral cavity: a light microscopic and immunohistochemical study with review of the literature from 1884 to 1992. EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1994; 30B:1-7. [PMID: 9135966 DOI: 10.1016/0964-1955(94)90043-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Leiomyoma is the most common benign neoplasm in the uterus and stomach but is rare in the oral cavity. There were only 5 oral cases in a series of 7748 leiomyomas of all sites. Benign smooth muscle neoplasms are classified into leiomyoma (solid leiomyoma), angiomyoma (vascular leiomyoma) and epithelioid leiomyoma (leiomyoblastoma). 6 cases diagnosed as leiomyoma were retrieved from the files of two oral biopsy services over the past 25 years. A light microscopic study including trichrome and phosphotungstic acid haematoxylin (PTAH) stains, and an immunohistochemical study with the following markers: desmin, muscle specific actin, myoglobin, vimentin, S-100 protein, neuron-specific enolase, factor VIII and Ulex europeus were done with suitable controls. The haematoxylin and eosin and Masson's trichrome stains supported a diagnosis of leiomyoma in all 6 cases but PTAH was positive in only 3 of them. The immunohistochemical study confirmed the diagnosis of leiomyoma in 3 cases. The other 3 were identified as granular cell tumour, myofibroma and neurofibroma, respectively. The review of the literature contributed the following data: mean age was 41 and median age 39 in 134/142 patients. A male sex prevalence 72/137 patients (54.0%) was noted. The lips were the most common site with 39 cases (27.46%) followed by the tongue 26 (18.30%), cheeks and palate 22 (15.49%), gingiva 12 (8.45%), and mandible 8 (5.63%). Prognosis of oral leiomyomas is excellent. Immunohistochemistry is a precise and reliable method for definitive diagnosis of oral leiomyoma.
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Affiliation(s)
- E Baden
- New Jersey Dental School, University Heights, Newark 07103-2400, USA
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Kawakami T, Hasegawa H, Chino T. A transmission electron microscopic study of two cases of oral smooth muscle neoplasm. J Oral Maxillofac Surg 1987; 45:551-5. [PMID: 3473207 DOI: 10.1016/s0278-2391(87)80022-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Two cases of smooth muscle tumors that had appeared in the oral regions were examined by means of histopathology and electron microscopy. One was a case of angiomyoma that appeared in the lip of a 33-year-old man, and the other was a case of leiomyosarcoma in the maxilla of a 63-year-old woman. The results of the examination of both cases were as follows: the benign tumor (angiomyoma) was composed of mainly mature smooth muscle cells having dark cytoplasm, and the malignant tumor (leiomyosarcoma) consisted mainly of two types of cells, undifferentiated mesenchymal cells or fibroblast-like cells (type I) and myofibroblast-like cells (type II). Based upon these results, the relationship between the myogenous differentiation and the component cell types, and biological behavior of these smooth muscle tumors was discussed.
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