Leiomyosarcomas are rare malignant mesenchymal neoplasms originating from smooth muscle cells. Although leiomyosarcoma is commonly located in the female reproductive system, gastrointestinal tract, and subcutaneous tissues, it is a rare entry in the head and neck area, probably due to the scarcity of smooth muscle tissue in this topographical region. Herein we present a histopathological case report of a 60-year-old male with a slow-growing painless mass on the middle third of the right lateral lingual margin, with focal ulceration measuring 1x1.5cm. After gross excision, histopathology revealed pleomorphic spindle cells, some with bizarre nuclei and abundant pathological mitotic activity with a tendency to grow in a fascicular pattern. As the patient had the demographic characteristic and risk factors for oral cavity squamous cell carcinoma, a spindle-shaped variety (sarcomatoid) variety was suspected, and immunohistochemistry with a broad set of antibodies was used to prove the histogenetic group of the tumor. As the tumor was pan-cytokeratin and desmin negative, focally positive for caldesmon, and positive for smooth muscle actin, the diagnosis of pleomorphic leiomyosarcoma of the tongue was established.
Keywords: head and neck malignancy; leiomyosarcoma; pathology; spindle shape tumor; tongue.
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