Persistent idiopathic unilateral hypoglossal nerve palsy.

phism; and 4) bizarre cell forms.12 Myofibrils are also present in some cases but are not required for the diagnosis.12 It must be borne in mind that these microscopic findings are only seen in cases of well-differentiated leiomyosarcoma.2 Masson's trichome staining and immunohistochemical evaluation for muscle antigen separates of leiomyosarcoma from other sarcomas, and it is helpful in diagnosis.4,5 Positive reactions for desmin, vimentin, and smooth-muscle actin have been demonstrated in leiomyosar-coma.3,13J4 The case presented fulfilled these criteria and confirmed the diagnosis of leiomyosarcoma. Surgical resection with a margin of normal tissue is the preferred treatment for superficial and peripheral leiomyosarcoma.* Regional lymph node dissection is only recommended if there is clinical evidence of lymphadenopathy.8J5 Unfortunately, the prognosis of this tumor cannot be predicted on either a clinical or histologic basis. Local recurrence and cervical and lung metastasis have been reported in nearly 40% of the cases.xF The high rate of recurrence shows that this tumor, despite its well circumscribed appearance, has a tendency to infiltrate the surrounding tissues. Therefore, follow-up for at least 5 years is strongly advised. et al: Primary leiomyosarcoma of the maxilla with regional lymph node metastasis: Report of a case and review of the literature. Report of a case and review of the literature pertaining to smooth-muscle tumors of the oral cavity.coma of the maxilla: Report of a case and review of the literature. Hypoglossal nerve palsy (HNP) can occur when a lesion is located in the bulbar nucleus or distal to it.l In such cases, the tongue, when at rest within the oral cavity, deviates toward the unaEected side. However, when protruded, the tongue deviates toward the affected side under the influence of the intact genio-glossus. Fasciculations may be observed in the paretic region, although over time the affected hemitongue undergoes progressive atrophy.2 The causes of nuclear paralysis of the hypoglossal nerve are multiple and include motor neuron disorders and syringobulbia. Among the former, the most common cause is amiotrophic lateral sclerosis, in which atrophy and hyperreflexia are combined.3 When the motor nuclei of the spinal cord or bulbar nucleus are affected, the result is progressive bulbar paralysis, which manifests as dysphonia, dysphagia, and speech problems, with fasciculations and bilateral atrophy of