Abstract
A 36-year-old female patient was referred to the Oral and Maxillofacial Surgery Service, at the Pontifical Catholic University of Minas Gerais (PUC-MG), to evaluate a lesion observed during a routine radiographic exam. Extraoral examination demonstrated a small increase of volume in the region and cervical lymphadenopathy. Intraoral examination demonstrated a discrete swelling in the vestibular region of the ramus of the mandible. Cone-beam CT showed a hypodense osteolytic image located in the region of the mandible angle below the mandibular canal, with destruction of the cortex. Differential diagnoses included malignant mesenchymal neoplasm and intraosseous squamous cells carcinoma. Incisional biopsy revealed a tumor mass with fascicles of interlacing spindle-shaped cells, abundant eosinophilic cytoplasm and large nuclei exhibiting atypia. Immunohistochemical technique to vimentin, HHF35, h-caldesmon, AE1AE3, desmin, and SMA was positive. Ki-67 proliferation index was 30%. A diagnosis of pleomorphic leiomyosarcoma grade 3 was made. The patient was referred to treatment and 4 months after diagnosis she died.
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