Metastatic leiomyosarcoma in the oral cavity: Case report with protein expression profiles
Introduction
Leiomyosarcoma (LMS) is found rarely in the oral cavity and is associated with aggressive clinical behaviour and low survival. This report describes a LMS in the right upper buccal gingiva metastasized from a primary lesion in the uterus. Total seven cases of metastatic LMS to the oral cavity, including our own, have been published in the English literature to date. Clinical, histological, immunohistochemical, and immuno-blot detections using 26 antibodies against different factors related to the proliferation, apoptosis, necrosis, and angiogenesis were performed in order to screen for expression of different proteins in the metastatic LMS.
Section snippets
Case report
A 56-year-old Korean woman was referred to the Department of Oral and Maxillofacial Surgery, Kangnung National University Dental Hospital, complaining of painful swelling with a necrotic ulcer measuring roughly 4.0 × 3.0 cm on the right upper buccal gingiva (Fig. 1A). Cervical or submandibular lymphadenopathy was not detected. She had no previous dental history relevant to the lesion but had undergone a total hysterectomy with bilateral salpingo–oophorectomy for a diagnosis of LMS, nine months
Discussion
In general, soft tissue sarcomas, including LMSs of the head and neck, aggressively invade surrounding tissues and disseminate haematogenously. Dissemination is frequently to the lungs, and regional lymph node involvement tends to occur later. LMS has a higher propensity to metastasize than do fibrosarcoma and liposarcoma (Hajdu, 2007, Ethunandan et al., 2007). Metastatic LMSs to the oral cavity are extremely rare, and we were able to review only six cases of metastatic LMS to the oral cavity
Conclusions
The prognosis of metastatic LMS is generally poor, and five patients did not survive more than two years after the initial diagnosis of intraoral metastatic lesion (Kaziro, 1981, Bogart et al., 1990, Allen et al., 1993, Vora and Levin, 2003). When compared with the immunoreactions of normal gingiva and primary uterine LMS, most oncogenes for cellular proliferation and angiogenesis in the metastatic oral LMS were more intensely expressed. These data suggest that rapid proliferation of the
Conflict of interest
There are no conflicts of interest in this article.
Acknowledgement
This work was supported by the Korea Research Foundation Grant funded by the Korean government (MOEHRD, Basic Research Promotion Fund) (KRF-2009-R1A4A002-0075286).
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