Inflammatory leiomyosarcoma of the head and neck: Case report

Nandi Viljoen; Gerrit Viljoen; Johannes J Fagan; Dhirendra Govender

doi:10.1016/j.ijscr.2021.105907

Inflammatory leiomyosarcoma of the head and neck: Case report

Int J Surg Case Rep. 2021 May:82:105907. doi: 10.1016/j.ijscr.2021.105907. Epub 2021 Apr 27.

Authors

Nandi Viljoen¹, Gerrit Viljoen², Johannes J Fagan³, Dhirendra Govender⁴

Affiliations

¹ Division of Anatomical Pathology, Faculty of Health Sciences, University of Cape Town, South Africa; National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.
² Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa. Electronic address: dr.gerrit.viljoen@gmail.com.
³ Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa.
⁴ Division of Anatomical Pathology, Faculty of Health Sciences, University of Cape Town, South Africa; PathCare, Claremont, Cape Town, South Africa.

Abstract

Introduction and importance: Primary sarcomas in the head and neck region are rare. Inflammatory leiomyosarcoma was first described in 1995. The case reported herein is the first reported inflammatory leiomyosarcoma occurring in the head and neck.

Presentation of case: A 37-year-old male presented with a long history of an asymptomatic slowly enlarging neck mass. Examination revealed a firm mass in the lower third of the right sternocleidomastoid muscle. Computerized tomography and magnetic resonance imaging showed a lobulated, well-circumscribed tumour with malignant features. A wide local excision was performed and histopathological examination confirmed an inflammatory leiomyosarcoma.

Discussion: Inflammatory leiomyosarcoma is a recently described peculiar soft tissue tumour with histological features overlapping conventional leiomyosarcoma, and dense lymphocytic inflammation and immunohistochemical reactivity for both smooth and skeletal muscle markers. These are indolent tumours and wide local excision is curative.

Conclusion: This case highlights the importance of considering primary sarcomas in the differential diagnosis of asymptomatic head and neck masses.

Keywords: Case report; Head and neck; Leiomyosarcoma; Sarcoma.