Oral Leiomyoma-Case Report

Oral leiomyomas are rare and account for 0.42% of all benign tumors of the oral cavity. A typical leiomyoma can be diagnosed through examination of hematoxylin and eosin-stained tissue section by an experienced pathologist, but it is sometimes difficult to differentiate an atypical leiomyoma from a spindle cell soft tissue tumor and needs immunohistochemical stain for a confirmatory diagnosis. We reported a leiomyoma arising from the anterior floor of the mouth in a 59-year-old male patient. The mass measured 1.2×1.0×0.6 cm. It was bilobular in shape, elastic in consistency, and covered by an intact, smooth, pink oral mucosa. Periapical radiography revealed no specific finding. The mass was totally excised under local anesthesia. Histopathologically, the tumor was well-demarcated and surrounded by a thin layer of fibrous connective tissue with minor salivary glands. It was highly cellular and composed of spindle-shaped cells that exhibited cigar-shaped nuclei and eosinophilic cytoplasm and were arranged in whirls and interlacing bundles. Mitotic figures were present but rare in number. Masson's trichrome stain showed red-stained muscle cells randomly dispersed in a light blue-stained stroma made up of collagen fibers. Immunohistochemically, the tumor cells were diffusely and strongly positive for myogenin and vimentin, moderately positive for smooth muscle actin and neuron-specific enolase, and weakly positive for actin, but were negative for desmin, myosin, myoglobulin, and S-100 protein. Many slit-like vascular channels in the stromal connective tissue were highlighted by the anti-CD31 and anti-CD34 immunostains. A solid leiomyoma was diagnosed. The patient was regularly followed up in the dental clinic. No recurrence of the tumor was found 3 months later. We suggest that an oral leiomyoma may need immunohistochemical stain with a panel of muscle-specific antibodies to confirm the histopathological diagnosis.

並列關鍵字

leiomyoma ； oral cavity ； immunohistochemistry

國際替代計量

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