Leiomyosarcoma of the tongue; Report of a case

Soft tissue sarcomas arising in the head and neck are rare among adults. They account for approximately 10% of all soft tissue sarcomas and approximately 1% of head and neck tumors. Leiomyosarcomas are among the unusual soft tissue sarcomas in the head and neck which account about 0.2% of the cases in the reported series(1). Leiomyosarcoma of the tongue is a very rare tumor. Reviewing of literature by Aydin et al. revealed that there were 80 cases of oral cavity leiomyomas and 26 cases of leiomyosarcoma(2), but only 5 cases originated from the tongue(2). The optimal treatment is complete resection. Although radical resection alone results in a high rate of local control, achieving a complete compartmental resection in the head and neck especially oral cavity is usually not feasible. Local recurrence rate for high grade soft tissue sarcoma after a wide local excision may be as high as 50%(1). Thus, most patients with soft tissue sarcomas of head and neck receive post operative adjuvant radiotherapy (RT), including those with low grade lesions(1). The 5-year local control rates of combination of surgery and RT in soft tissue sarcomas arising in the head and neck range 60-70%, which are similar to the 5-year cause-specific and overall survival rates(1). The value of adjuvant chemotherapy is unclear. Few data directly pertain to the efficacy of chemotherapy for these tumors, so it is necessary to extrapolate data from soft tissue sarcomas arising in the other site such as doxorubicin-based regimens(1). As leiomyosarcomas of the oral cavity are among the rare soft tissue sarcomas in the head and neck, the best treatment options seems to be surgery combined with radiotherapy to improve local control. It may be possible to know the best approaches by practicing more cases.