Oral leiomyosarcoma in childhood - Report of a case with fine needle aspiration cytology

BACKGROUND: Leiomyosarcomas are rare tumors in the pediatric age group, and occurrence of this neoplasm in the oral cavity is exceedingly rare. This a rticle high lights the fine needle aspiration (FNA) cytology diagnosis of a case of recurrent oral leiomyosarcoma in childhood. CASE: An 11-year-old male noticed a swelling in the oral cavity near the le ft lower jaw. It was excised and diagnosed as leiomyosarcoma on histopathol ogy. Four months later the patient presented with a progressive swelling in the oral cavity that extended to the lower jaw. The recurrent swelling was subjected to FNA, and its cytologic features were consistent with leiomyos arcoma. There was a very good initial response to chemotherapy and radiatio n therapy. However, because of noncompliance with advice for further therap y, the patient had a second local recurrence and dissemination of the disea se to the skeletal system, abdomen and thorax. FNA cytology diagnosis of th e second locally recurrent lesion and abdominal mass were consistent with l eiomyosarcoma. Immunocytochemical staining revealed a positive reaction in the cytoplasm of tumor cells for vimentin and desmin in the FNA smear and p araffin section, respectively. CONCLUSION Fine needle aspiration cytology is a useful technique for detect ion of recurrence and metastasis during follow-up of childhood oral leiomyo sarcoma.